Dr (TCM) Attilio D'Alberto
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Fertility Expert Fertility Wokingham Fertility Acupuncture Fertility London
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"After 4 years of trying to conceive, I had a total sum of 6 weeks treatment before falling pregnant"

Acupuncture and Chinese Herbal Medicine Research for Infertility

Acupuncture improves female fertility

  • Acupuncture reduces conception time by almost 50%: The global average of couples with fertility problems is around 9%. Assisted reproductive technologies are often inaccessible. Evidence points to acupuncture offering an opportunity to promote natural fertility. This study asked whether providing a multiphasic fertility acupuncture protocol to women with sub/infertility would increase their awareness of fertility and achieve normalisation of their menstrual cycle compared with a lifestyle control. Those receiving the acupuncture conceived within an average of 5.5 weeks compared to 10.67 weeks for the lifestyle only group (p = 0.422). The acupuncture protocol tested influenced women who received it compared to women who used lifestyle modification alone: their fertility awareness and wellbeing increased, and those who conceived did so in half the time. Cochrane et al. (2016) Prior to Conception: The Role of an Acupuncture Protocol in Improving Women’s Reproductive Functioning Assessed by a Pilot Pragmatic Randomised Controlled Trial. Evid Based Complement Alternat Med; 3587569. doi: 10.1155/2016/3587569.
  • Acupuncture and Chinese herbs helps infertility: Acupuncture and Chinese herbs prevent infertility after emergency ectopic pregnancy surgery. Ectopic pregnancies occur when a fertilized egg does not implant in the uterus. Qihai (CV5) and Tianshu (ST25) are commonly used. A common form of ectopic pregnancy is a tubal pregnancy wherein the fertilized egg remains in one of the fallopian tubes. The fertilized egg cannot survive. It is a life-threatening condition that may require emergency surgery or an injection of methotrexate to stop cell growth. Unfortunately, this may lead to residual blockage of the fallopian tubes and subsequent infertility. Li et al. (2014). Clinical Observations on the Effect of Combined Treatment with Acupuncture and Medicine on Tubal Patency after Ectopic Pregnancy Surgery. Shanghai Journal of Acupuncture and Moxibustion, 33(9).
  • Acupuncture reduces FSH-levels and increases antral follicle count, AMH-levels and pregnancy rates: The aim of this study was to investigate the effect of transcutaneous electrical acupoint stimulation (TEAS) on ovarian reserve in patients with diminished ovarian reserve undergoing in vitro fertilization and embryo transfer. A total of 240 patients were randomly divided into the Han's acupoint nerve stimulator TEAS treatment (TES), comforting false Han's placebo (FHP), artificial endometrial cycle treatment (AEC), and control (CON) groups. TEAS and AEC treatments could improve basal endocrine levels in patients, and increase the number of oocytes retrieved and high-quality embryos. TEAS treatment could improve the clinical pregnancy rate in patients with decreased ovarian reserve during in vitro fertilization and embryo transfer cycles. Zheng et al. (2015) Effects of transcutaneous electrical acupoint stimulation on ovarian reserve of patients with diminished ovarian reserve in in vitro fertilization and embryo transfer cycles. J Obstet Gynaecol Res, Volume 41, Issue 12, 1905–1911. doi: 10.1111/jog.12810.
  • Acupuncture reduces fertility stress: Acupuncture may be a useful intervention to assist with the reduction of infertility-related stress. At the end of the 8-week intervention, women in the acupuncture group reported significant changes on two domains on the Fertility Problem Inventory with less social concern (mean difference [MD] -3.75, 95% confidence interval [CI] -7.58 to 0.84, p=0.05), and less relationship concern (MD -3.66, 95% CI -6.80 to -0.052, p=0.02). There were also trends toward a reduction of infertility stress on other domains, and a trend toward improved self-efficacy (MD 11.9, 95% CI -2.20 to 26.0, p=0.09) and less anxiety (MD -2.54, 95% CI -5.95 to 0.86, p=0.08) in the acupuncture group compared with the wait-list control. Smith, et al. (2011) The effect of acupuncture on psychosocial outcomes for women experiencing infertility: a pilot randomized controlled trial. Journal of Alternative and Complementary Medicine, 2011 Oct;17(10): 923-30.
  • Acupuncture better than clomid (clomiphene) for conception: A randomised controlled trial with 240 women with endocrine dysfunctional infertility, 160 receiving acupuncture and 80 clomiphene. The pregnancy rate was 65% in the acupuncture group and 45% for the medication, a statistically significant difference (p0.5) Yang et al. (2005) Controlled study on acupuncture for treatment of endocrine dysfunctional infertility. Zhongguo Zhenjiu; 25(5): 299-300.
  • Acupuncture reduces stress and aids reslilence: Eight interviews were conducted, six women used acupuncture as an adjunct treatment during assisted fertility and two women used acupuncture to enhance their natural fertility. Interviews examined participant’s perspective of acupuncture, its relationship to fertility and the outcome of ART, and their experience of receiving acupuncture. A narrative analysis was undertaken and analysed thematically. Participants all expressed confidence in the ability of acupuncture to contribute to their reproductive decision in a positive way. They described acupuncture as an adjunct to pregnancy attempts that was positive since it gave them a sense of control and a strategy for improving their chances. Women were unable to locate acupuncture as a causative factor in a resulting pregnancy, however all women described acupuncture as instrumental in an increased sense of wellbeing, self-confidence, emotional balance and reduced anxiety. All experienced increased resilience. The positive effects of acupuncture emerged as being concerned with the treatment and the role of the acupuncturist. Acupuncture is an effective and low intensity procedure for increasing women’s resilience in the repetitive and stress-inducing time of pregnancy attempts, with or without medical treatment. The instrumental role of the acupuncture therapist in increasing resilience is a finding that has not emerged in previous studies and has implications for patient management. Smith et al. (2009) Understanding women’s views towards the use of acupuncture while undergoing IVF treatment. Journal of Paediatrics and Child Health 45 (2009) A10–A71.
  • Acupuncture better than clomid at improving fertility: Fifty cases were randomized into an acupuncture group (30 cases) and a medication (Clomiphene) group (20 cases). High phase score (HPS) was adopted to evaluate the luteal function before and after treatments, coupled with observation on the changes of E2, progesterone (P), follicles and endometrium. The total effective rate in the acupuncture group was 93.4%, versus 70.0% in the medication group, showing a significant difference (P0.05). Both acupuncture and Clomiphene can substantially improve the luteal function; however, acupuncture can get a better effect in improving the endometrium and a lower miscarriage rate than Clomiphene. (2012) Effect of acupuncture on infertility due to luteal phase defect. J. Acupunct. Tuina. Sci, 10 (2): 85-88. DOI: 10.1007/s11726-012-0577-x.
  • Acupuncture enhances fertility when clomid is used: The present study aimed to evaluate whether the following endometrial receptivity factors: the endometrial morphology, the hormone concentrations, and the protein expression of endometrial leukaemia-inhibitory factor (LIF) and osteopontin (OPN) could be improved by the acupuncture in clomiphene citrate (CC)-induced rat model during implantation period. Results showed that, compared with the CC group, glandular development advanced, the serum estradiol levels decreased significantly, and the glandular area and endometrial LIF and OPN expression were significantly higher in acupuncture group. There were no significant differences in serum progesterone levels, endometrial thickness, and stromal area between groups. These results suggest that acupuncture can improve certain aspects of endometrial receptivity in CC-induced rat model during implantation period, which might result in endometrial state better to female reproduction. Fu, H, et al. (2011) Acupuncture on the Endometrial Morphology, the Serum Estradiol and Progesterone Levels, and the Expression of Endometrial Leukaemia-inhibitor Factor and Osteopontin in Rats. Evidence-Based Complementary and Alternative Medicine Volume 2011, Article ID 606514. doi:10.1155/2011/606514.
  • Acupuncture and Chinese herbs clear blocked fallopian tubes and improve fertility: Acupuncture and herbs clear fallopian tube obstructions and restore fertility. Researchers from the Maternal and Child Health Care Hospital of Puyang City tested a four part Traditional Chinese Medicine (TCM) protocol for restoring fallopian tube patency. The acupuncture and herbal medicine protocol led to the successful clearing of hydrosalpinx and other fallopian tube obstructions. In addition, the acupuncture and herbal medicine protocol outperformed a control group receiving medications. Ding et al. (2014) Clinical study on the treatment of fallopian tube obstructive infertility with acupuncture and Chinese medicine. Modern Journal of Integrated Traditional Chinese and Western Medicine; 23 (17).
  • Acupuncture treats LH defect syndrome: Sixty cases of infertility due to luteal phase defect were treated with herbs to tonify the kidney and regulate the menstrual cycle. After the treatment, the hyperthermal phase score of basal body temperature (BBT) was markedly increased (P less than 0.05), the hyperthermal phase 7-8 days after ovulation improved (P less than 0.001), the transitional period of BBT remarkably shortened, and the pregnancy rate in 32 uncomplicated cases of luteal phase defect was 56%. The close relationship between luteal phase defect and the kidney deficiency syndrome in TCM was discussed. The key points of the treatment included coordination of yin and yang, regulation of qi and blood, and combination of tonification with reduction. Lian (1991) TCM treatment of luteal phase defect--an analysis of 60 cases. J Tradit Chin Med; 11(2):115-20.
  • Acupuncture regulates immune factors TH1/TH2 and Natural Killer Cells: Acupuncture is probably the most popular alternative therapy practiced in the United States, Europe and many Asian countries. It has been applied clinically for more than 5 thousand years according to the ancient oriental medical theory. A great deal of acupuncture research has been achieved, with particular efforts toward understanding the pain control effects. In addition to the analgesic effect of acupuncture, an increasing number of studies have demonstrated that acupuncture treatment can control autonomic nerve system functions such as blood pressure regulation, sphincter Oddi relaxation, and immunemodulation. Although only a limited number of controlled studies have assessed the efficacy of acupuncture, increasing clinical evidences support that EA treatment is effective for various immunological diseases including allergic disorders, infections, autoimmune diseases and immunodifficiency-syndromes. This review will address the mechanism of acupuncture in modulating various immune responses and the relationship between acupuncture mediated immune regulation and neurological involvement. Kim, et al. (2010) Acupuncture and immune modulation. Autonomic Neuroscience: Basic and Clinical 157, 38–41. doi:10.1016/j.autneu.2010.03.010.
  • Acupuncture regulates Nautral Killer Cell activity: Electro-acupuncture stimulation (voltage intensity, 1 to 5 V; duration, 1 ms; frequency, 1 Hz) was applied to bilateral ST36 acupoints once a day (1 h) for 3 d. NK cytotoxicity was measured by the standard 4-h 51Cr release assay. Successive acupuncture treatment for 3 d significantly enhanced splenic NK cytotoxicity (p 0.001) on the first day after final treatment as compared to that of the control. However, similar stimulation to abdominal muscle did not influence splenic NK cytotoxicity. We also examined endogenous cytokine activities in aqueous spleen extracts prepared from acupunctured and control rats. The extracts from rats acupunctured at the ST36 acupoint contained high levels of interleukin (IL)-2 and interferon (IFN)-gamma as compared to those of abdominal muscle acupunctured and non-acupunctured control rats (p 0.01). Furthermore,a significant positive correlation (p 0.01) was observed between the levels of each cytokine tested and splenic NK cytotoxicity. The same positive correlation was also observed between the levels of IL-2 and IFN-gamma (p 0.01). These observations indicate that electro-acupuncture stimulation of the ST36 acupoint enhances splenic NK cytotoxicity and that IL-2 and IFN-gamma may function, at least in part, in the regulation of NK cell activity in this system. Yu, et al. (1997) Enhancement of splenic interferon-gamma, interleukin-2, and NK cytotoxicity by S36 acupoint acupuncture in F344 rats. Jpn J Physiol; 47(2): 173-8.
  • Acupuncture and herbs resolves pelivc inflammatory disease: Acupuncture and Chinese herbs eliminate pelvic inflammatory disease (PID). This disorder is often due to an infection in the uterus, fallopian tubes, or ovaries. PID may cause infertility due to residual scarring or congealed exudate. Chlamydia and gonorrhea are common etiologies but PID may be caused many other pathogenic influences. Zhou, et al (2014). Clinical Study on Chronic Pelvic Inflammatory Disease with Syndrome of Damp-heat and Blood-stasis by Qing-Re Li-Shi Hua-Yu Decoction Combined with Acupuncture Therapy. World Science and Technology – Modernization of Traditional Chinese Medicine, 16 (12).
  • Acupuncture regulates the hypothalamic-pituitary-ovarian system: This article summarizes the studies of the mechanism of electroacupuncture (EA) in the regulation of the abnormal function of hypothalamicpituitary-ovarian axis (HPOA) in our laboratory. Clinical observation showed that EA with the effective acupoints could cure some anovulatory patients in a highly effective rate and the experimental results suggested that EA might regulate the dysfunction of HPOA in several ways, which means EA could influence some gene expression of brain, thereby, normalizing secretion of some hormones, such as GnRH, LH and E2. The effects of EA might possess a relative specificity on acupoints. Chen. (1997) Acupuncture Normalizies Dysfunction of Hypothalamic-Pituitary-Ovarian Axis. Acupuncture & Electro-Therapeutics Research, Volume 22, Number 2, 97-108(12)
  • Moxibustion increases the number of ovarian granulosa cells: Our results showed that mild warm moxibustion (MWM) modulated the circulating levels of estradiol and follicle-stimulating hormone and their receptors and inhibited apoptosis in the ovaries, similar to the effect of estrogen. Further investigation revealed that the effects of MWM on ovary tissues and cultured GCs were mediated by the modulation of the activity of Forkhead box protein O1 and involved the JAK2/STAT3 pathway. Shi et al. (2015) Moxibustion Reduces Ovarian Granulosa Cell Apoptosis Associated with Perimenopause in a Natural Aging Rat Model. Evid Based Complement Alternat Med: Article ID 742914. doi: 10.1155/2015/742914.
  • Acupuncture improves ovarian reserve: Eligible patients with diminished ovarian reserve received electric acupuncture for 12 weeks: five times a week for 4 weeks followed by three times a week for 8 weeks. The primary outcome was the change in mean follicle-stimulating hormone (FSH) level at week 12. Mean luteinising hormone (LH) and serum oestradiol (E2) levels, FSH/LH ratios and symptom scale scores were simultaneously observed. Twenty-one patients with diminished ovarian reserve were included in the final analysis. Mean FSH levels fell from 19.33±9.47 mIU/mL at baseline to 10.58 ± 6.34 mIU/mL at week 12 and 11.25±6.68 mIU/mL at week 24. Change in mean FSH from baseline was -8.75±11.13 mIU/mL at week 12 (p=0.002) and -8.08±9.56 mIU/mL at week 24 (p=0.001). Mean E2 and LH levels, FSH/LH ratios and irritability scores were improved at weeks 12 and/or 24. Approximately 30% of patients reported subjective increases in menstrual volume after treatment. Electric acupuncture may modulate reproductive hormone levels and the effects seem to persist for at least 12 weeks after treatment with no significant side effects. Electric acupuncture may improve the ovarian reserve of patients with diminished ovarian reserve. Wang Y, et al. (2016) Electroacupuncture for reproductive hormone levels in patients with diminished ovarian reserve: a prospective observational study. Acupunct Med; 0:1–6. doi:10.1136/acupmed-2015-011014.
  • Acupuncture reduces depression by regulating the hypothalamus-pituitary-adrenocortical axis: Wistar rats were selected for subjects. A rat model of depression was made by individually housing with unpredicted chronic moderate stimuli. Changes in behavior and hypothalamus-pituitary-adrenocortical axis were examined in rat models of stress-induced depression. Meanwhile, the intervening effect of acupuncture was evaluated and the curative effects of different acupuncture methods compared. CORT and ACTH contents of serum were significantly higher in the model and normal saline groups than in the control group (P0.05), significantly lower in the hand acupuncture and electroacupuncture groups than in the model group (P0.05) and significantly lower in the medication group than in the normal saline group (P0.05). There were no significant differences between the hand acupuncture, electroacupuncture and medication groups. Acupuncture of Baihui (GV 20) and Taichong (LR 3) has a marked antidepressant effect. Its mechanism may be related to the regulation of HPA axis by acupuncture. Sun, et al. (2007) Influence of Acupuncture on HPA Axis in a Rat Model of Chronic Stress-induced Depression. Journal of Acupuncture and Tuina Science, Volume 5, Issue 4, 205–208. DOI: 10.1007/s11726-007-0206-2.
  • Acupuncture increases blood flow to the ovaries: The purpose of the present study was to investigate changes in ovarian blood flow (OBF) in response to electro-acupuncture (EA) stimulation at different frequencies and intensities in anaesthetized rats. Whether the ovarian sympathetic nerves were involved in OBF responses was elucidated by severance of the ovarian sympathetic nerves. In addition, how changes in the systemic circulation affected OBF was evaluated by continuously recording blood pressure. OBF was measured on the surface of the left ovary using laser Doppler flowmeter. Acupuncture needles with a diameter of 0.3 mm were inserted bilaterally into the abdominal and the hindlimb muscles and connected to an electrical stimulator. Two frequencies—2 Hz (low) and 80 Hz (high)— with three different intensities—1.5, 3, and 6 mA—were applied for 35 s. Both low- and high-frequency EA at 1.5 mA and high-frequency EA at 3 mA had no effect on OBF or mean arterial blood pressure (MAP). Low-frequency EA at 3 and 6 mA elicited significant increases in OBF. In contrast, high-frequency EA with an intensity of 6 mA evoked significant decreases in OBF, followed by decreases in MAP. After severance of the ovarian sympathetic nerves, the increases in the OBF responses to low-frequency EA at 3 and 6 mA were totally abolished, and the responses at 6 mA showed a tendency to decrease, probably because of concomitant decreases in MAP. The decreased OBF and MAP responses to high-frequency EA at 6 mA remained after the ovarian sympathectomy, and the difference in the responses before and after ovarian sympathectomy was nonsignificant. In conclusion, the present study showed that low-frequency EA stimulation increases OBF as a reflex response via the ovarian sympathetic nerves, whereas high-frequency EA stimulation decreases OBF as a passive response following systemic circulatory changes. Stener-Victori et al. (2003) Ovarian blood flow responses to electro-acupuncture stimulation at different frequencies and intensities in anaesthetized rats. Autonomic Neuroscience: Basic and Clinical 108, 50– 56.
  • Acupuncture regulates FSH, LH, oestrogen and progesterone levels: Ovulatory dysfunction is commonly seen in gynecology clinic. It may cause infertility, anemia, functional uterine bleeding and a variety of complications. This research according to TCM theory records treating with acupuncture 34 patients suffering from ovulatory dysfunction. Changes in clinical symptoms and some relative targets are reported, plus findings in animal experiments. The theory concerning the generative and physiologic axis of women, this research involved the following points; Ganshu (UB 18), Shenshu (UB 23), Guanyuan (REN 4), Zhongji (REN 3), and Sanyinjiao (SP 6). The reinforcement and reduction of acupuncture enables it to strengthen liver and kidney. Through the Chong and Ren channels it nourishes uterus to adjust the patient's axis function and recover ovulation. Treated on an average of 30 times, the patients' symptoms improved to varying degrees. The marked effective rate was 35.29%, the total effective rate being 82.35%. BBT, VS, CMS, and B ultrasonic picture all improved to some degree. The results also showed that acupuncture may adjust FSH, LH, and E2 in two directions and raise the progesterone level, bringing them to normal. The animal experiments confirmed this result. Results showed that acupuncture may adjust endocrine function of the generative and physiologic axis of women, thus stimulating ovulation. The results of this research will provide some scientific basis for treating and further studying this disorder. Mo et al. (1993) Clinical studies on the mechanism for acupuncture stimulation of ovulation. J Tradit Chin Med Jun;13 (2): 115-9 (ISSN: 0254-6272).

Acupuncture improves male fertility

  • Acupuncture and moxibustion increase testosterone levels: Partial androgen deficiency of the aging male (PADAM) is characterised by a deficiency in serum androgen levels. Both electroacupuncture (EA) and mild moxibustion (MM) can raise serum testosterone levels in PADAM. EA and MM were administered at BL23 and CV4 acupuncture points for 8 weeks. Both EA and mild MM significantly increased serum TT and FT levels with MM displaying superiority. P450scc, 17ß-HSD3 and SF-1 protein expression, and P450c17 and 3ß-HSD1 mRNA expression, were significantly increased and serum LH and FSH levels were significantly decreased. EA and MM at the BL23 and CV4 acupuncture points appear to be effective treatments for PADAM, and MM displays superior efficacy to EA. Ren et al. (2016) Effects and mechanisms of acupuncture and moxibustion on reproductive endocrine function in male rats with partial androgen deficiency. Acupunct Med, 34:136-143 doi:10.1136/acupmed-2014-010734.
  • Acupuncture can help men with a low sperm count: Semen samples of 20 patients with a history of azoospermia were examined by light microscope (LM) and scanning electron microscope (SEM), with which a microsearch for spermatozoa was carried out. These examinations were performed before and 1 month after acupuncture treatment and revealed that the study group originally contained three severely oligoteratoasthenozoospermic (OTA), two pseudoazoospermic and 15 azoospermic patients. The control group was comprised of 20 untreated males who underwent two semen examinations within a period of 2-4 months and had initial andrological profiles similar to those of the experimental group. No changes in any of the parameters examined were observed in the control group. There was a marked but not significant improvement in the sperm counts of severely OTA males following acupuncture treatment (average =0.7 f 1.1 x lo6 spermatozoa per ejaculate before treatment vs. 4.3 f 3.2 x lo6 spermatozoa per ejaculate after treatment). A definite increase in sperm count was detected in the ejaculates of 10 (67%) of the 15 azoospermic patients. Seven of these males exhibited post-treatment spermatozoa that were detected even by LM. The sperm production of these seven males increased si nificantly, from 0 to an average of l.5f2.4 x 10 spermatozoa per ejaculate (Z = - 2.8, PI 0.01). Males with genitak tract inflammation exhibited the most remarkable improvement in sperm density (on average from 0.3 f0.6 x lo6 spermatozoa per ejaculate to 8 3.3 f 3.2 x lo6 spermatozoa per ejaculate; Z = - 2.4, PI 0.02). Two pregnancies were achieved by the IVF-ICSI procedure. It is concluded that acupuncture may be a useful, nontraumatic treatment for males with very poor sperm density, especially those with a history of genital tract inflammation. Sherman et al. (2000) Does acupuncture treatment affect sperm density in males with very low sperm count? A pilot study. Andrologia 32, 31-39.
  • Acupuncture increases blood flow to the tesitcals: Eighty healthy male volunteers were randomly allocated to three groups in stage one and to a single group in stage two. In the first stage of the study, the abdominal acupuncture points ST-29 (guilai) were stimulated using simple needle insertion, 2 Hz burst EA or 10 Hz EA, in three different groups. In the second stage of the study, abdominal acupuncture points ST-25 (tianshu) were stimulated with the frequency found to be more effective in stage one. Stimulation was for 5 minutes in each group. Intervention(s): Electroacupuncture and Doppler flowmeter. Main Outcome Measure(s): Four groups were compared for volume flow and other related parameters of TBF. Result(s): The 10-Hz EA stimulation of ST-29 (guilai) increased TBF, but simple needle insertion and 2-Hz burst stimulation did not. The 10-Hz EA stimulation of ST-25 (tianshu) did not result in significant changes in TBF. Conclusion(s): For the first time point- and frequency-specific effects of abdominal EA on TBF are shown in humans. Further investigation is required to ascertain whether these findings may be helpful in the clinical treatment of infertile men. Cakmak, et al. (2008) Point- and frequency-specific response of the testicular artery to abdominal electroacupuncture in humans. Fertil Steril; 90: 1732–8
  • Acupuncture better than western medicine at improving sperm quality: A total of 12 studies involving 2,177 patients were included, the quality of which was evaluated as mediocre. For the treatment of male infertility acupuncture is reported to be equally effective as TMC and more effective than Western medicine, and its effectiveness is enhanced when applied in combination with either TCM or Western medicine. Acupuncture is distinctively efficacious in improving sperm quality. He, et al. (2015) Acupuncture treatment of male infertility: a systematic review. Zhonghua Nan Ke Xue, Jul;21(7):637-45.
  • Acupuncture treats oligoasthenozoospermia: A randomised single-blind placebo-controlled trial including 57 infertile men with severe oligoasthenozoospermia, which compared traditional Chinese medicine (TCM) acupuncture with placebo acupuncture. The TCM acupuncture group had a significantly higher percentage of motile sperm (World Health Organization categories A-C) than the placebo acupuncture group. Dieterle, et al. (2009) A prospective randomized placebo-controlled study of the effect of acupuncture in infertile patients with severe oligoasthenozoospermia. Fertility and Sterility; 92: 1340-3.
  • Acupuncture reduces low sperm count: A study that assessed the effects of acupuncture treatment on sperm output in patients with low sperm density associated with a high scrotal temperature. A total of 39 men were given acupuncture for a low sperm output. Based on 18 men with normal fertility (the control group), threshold scrotal skin temperature was set at 30.5oC, and temperatures above this were considered to be high. Accordingly, 34 of the 39 participants in the experimental group initially had high scrotal skin temperature; the other five had normal values. Scrotal skin temperature and sperm concentration were measured before and after acupuncture treatment. Following treatment, 17 of the 34 patients with hyperthermia, all of whom had genital tract inflammation, had normal scrotal skin temperature; in 15 of these 17 patients, sperm count increased. In the remaining 17 men with scrotal hyperthermia, neither scrotal skin temperature nor sperm concentration was affected by the treatment; however, 90% had high gonadotrophins or mixed aetiological factors. The five patients with initially normal scrotal temperatures were not affected by the acupuncture treatment. The researchers concluded that low sperm count in patients with inflammation of the genital tract seems to be associated with scrotal hyperthermia, which can be reversed with acupuncture treatment. Siterman, et al. (2009) Success of acupuncture treatment in patients with initially low sperm output is associated with a decrease in scrotal skin temperature. Asian Journal of Andrology; 11: 200-8.
  • Acupuncture can treat unexplained male infertility: A randomised controlled trial that evaluated the ultramorphologic sperm features of idiopathic infertile men after acupuncture therapy. A total of 40 men with idiopathic oligozoospermia, asthenozoospermia, or teratozoospermia took part. Twenty eight of the patients received acupuncture twice a week over a period of 5 weeks. The samples from the treatment group were randomised with semen samples from the 12 men in the untreated control group and evaluated by transmission electron microscopy. The data showed a significant increase after acupuncture in the percentage and number of sperm without ultrastructural defects. However, specific sperm pathologies in the form of apoptosis, immaturity, and necrosis showed no statistically significant changes between the control and treatment groups before and after treatment. The researchers concluded that idiopathic male infertility could benefit from acupuncture treatment, and result in a general improvement of sperm quality, specifically in the ultrastructural integrity of spermatozoa. Pei, et al. (2005) Quantitative evaluation of spermatozoa ultrastructure after acupuncture treatment for idiopathic male infertility. Fertility and Sterility; 84: 141-7.
  • Acupuncture increases semen quality: A randomised controlled treatment that evaluated the effect of acupuncture and moxa treatment on the semen quality in 19 men with semen abnormalities, such as low concentration, abnormal morphology and/or progressive reduced motility without apparent cause. Patients were either given acupuncture and moxa or sham acupuncture for 10 weeks. Semen analyses were performed before and after the treatment course. The patients given acupuncture had a significant increase in the percentage of normally-formed sperm compared to the sham group. Gurfinkel, et al. (2003) Effects of acupuncture and moxa treatment in patients with semen abnormalities. Asian Journal of Andrology; 5: 345-8.
  • Acupuncture helps men with low sperm count (azoospermia): Light microscope (LM) and scanning electron microscope (SEM) were used to examine semen before and 1 month after acupuncture treatment. The study group originally contained three severely oligoteratoasthenozoospermic, two pseudoazoospermic and 15 azoospermic patients. The control group was comprised of 20 untreated males who underwent two semen examinations within a period of 2-4 months and had initial andrological profiles similar to those of the experimental group. No changes in any of the parameters examined were observed in the control group. A definite increase in sperm count was detected in the ejaculates of 10 (67%) of the 15 azoospermic patients, 7 of whom exhibited post-treatment spermatozoa that were detected even by LM. The sperm production of these seven males increased significantly, from 0 to an average of 1.5 x 106 spermatozoa per ejaculate (p=0.01). Males with genital tract inflammation exhibited the most remarkable improvement in sperm density (on average from 0.3 x 106 spermatozoa per ejaculate to 3.3 x 106 spermatozoa per ejaculate; p=0.02). The researchers concluded that acupuncture may be a useful, nontraumatic treatment for males with very poor sperm density, especially those with a history of genital tract inflammation. Siterman, et al. (2001) Does acupuncture treatment affect sperm density in males with very low sperm count? A pilot study. Andrologia, 32: 31-9.
  • Acupuncture improves sperm activity in men with low fertility: The aim of this prospective controlled study was to assess the effect of acupuncture on the sperm quality of males suffering from sub fertility related to sperm impairment. Semen samples of 16 acupuncture-treated sub fertile patients were analyzed before and 1 month after treatment (twice a week for 5 weeks). In parallel, semen samples of 16 control untreated sub fertile males were examined. Two specimens were taken from the control group at an interval of 2-8 months. The expanded semen analysis included routine and ultramorphological observations. The fertility index increased significantly (p or = .05) following improvement in total functional sperm fraction, percentage of viability, total motile spermatozoa per ejaculate, and integrity of the axonema (p or = .05), which occurred upon treatment. The intactness of axonema and sperm motility were highly correlated (corr. = .50, p or = .05). Thus, patients exhibiting a low fertility potential due to reduced sperm activity may benefit from acupuncture treatment. Siterman, et al. (1997) Effect of acupuncture on sperm parameters of males suffering from sub fertility related to low sperm quality. Arch Androl, 39(2):155-61, Sep-Oct (ISSN: 0148-5016).

Chinese herbs improve female fertility

  • Chinese herbs twice as effective as fertility drugs: Our review suggests that management of female infertility with Chinese herbal medicine can improve pregnancy rates 2-fold within a 3–6 month period compared with Western medical fertility drug therapy. In addition, fertility indicators such as ovulation rates, cervical mucus score, biphasic basal body temperature, and appropriate thickness of the endometrial lining were positively influenced by CHM therapy, indicating an ameliorating physiological effect conducive for a viable pregnancy. Ried. (2015) Chinese herbal medicine for female infertility: An updated meta-analysis. Complementary Therapies in Medicine, Volume 23, Issue 1, 116-128.
  • Chinese herbs more benefical than IVF drugs: The management of female infertility with Chinese herbal medicine can improve pregnancy rates 2-fold within a 4 month period compared with Western Medical fertility drug therapy or IVF. Assessment of the quality of the menstrual cycle, integral to TCM diagnosis, appears to be fundamental to successful treatment of female infertility. Meta-analysis of RCTs suggested a 3.5 greater likelihood of achieving a pregnancy with CHM therapy over a 4-month period compared with WM drug therapy alone. Meta-analysis of selected cohort studies (n = 616 women) suggested a mean clinical pregnancy rate of 50% using CHM compared with IVF (30%) (p 0.0001). Reid, et al. (2011) Efficacy of Traditional Chinese Herbal Medicine in the management of female infertility: A systematic review. Complementary Therapies in Medicine Volume 19, Issue 6, 319-331, DOI: 10.1016/j.ctim.2011.09.003.
  • Chinese herbs treat immuology infertility: According to the microcosmic Syndrome Differentiation, immunological infertility is recognised as Kidney Yin Deficiency-Hyperactivity of Fire Syndrome. Zhibai Dihuang Pills, a recipe of Chinese medicinal herbs, was used to treat the infertile couples with antisperm and/or antizona pellucida antibodies in their blood serum. It was found that after the treatment, the antibodies were converted to negativeness in 81.3% of immunological infertile couples. All 8 cases of successful pregnancy occurred in 1-9 months after antibodies negative conversion and the negative status was maintained throughout the course of pregnancy. Li et al. (1995) Treatment of immunological infertility with Chinese medicinal herbs of ziyin jianghuo. Zhongguo Zhong Xi Yi Jie He Za Zhi15 (1) :3-5.

Chinese herbs improve male fertility

  • Huang Qi (Astragalus) increases sperm motility: Poor sperm motility is an important cause of male infertility. In an attempt to identify Chinese medicinal herbs that might improve human sperm motility in vitro, we screened water extracts of 18 herbs with a trans-membrane migration method which measured the percentage of sperm that moved across the 5 micron pores of a Nuclepore membrane from a semen-drug mixture into phosphate buffered saline during 2 hours incubation. Astragalus membranaceus was the only herb that showed a significant stimulatory effect. At 10 mg/ml, it increased the motility of sperm in semen to 146.6 ± 22.6 % of control. It also increased the motility of washed sperm to 138.2 ± 13.8% of control. Purification of the active component(s) from this herb as well as its application in assisted reproduction technology await further investigation. Hong et al. (1992) Astragalus membranaceus stimulates human sperm motility in vitro. Am J Chin Med; 20:289-294. doi:10.1142/S0192415X92000308.
  • Bu Zhong Yi Qi Tang protects male fertility: Chinese herbal medicine, " Hochuekkitto" is widely used for male infertility in Japan. There have been many reports concerning its clinical usefulness but very few reports of in vitro experiments studying the mechanism of its effects. In addition to stimulating germ cells, we analyzed its direct effects on sperm using computer assisted semen analyzer (CASA). Motile sperm were prepared using swim up technique from semen collected from ten healthy volunteers. Sperm movements (motility, velocity, linearity) were analyzed by CASA after adding either serum containing anti-sperm antibody (ASA) or normal serum with or without Hochuekkito. Two hours after adding serum with ASA, the decrease of sperm motility was significantly reduced from 25.1% (92.8% -->67.7%) to 12.5% (92.9% -->80.6%) by adding Hochuekkito. No significant difference in velocity and linearity was observed between two groups. By adding normal serum, any of three parameters differed significantly with or without Hochuekkito. Protective effects of Hochuekkito on sperm were suggested. Although normal sperm with ASA was used in this report, since the sperm of infertile patients are said to be more fragile, this results imply that direct protective effect is one of the mechanism of Hochuekkito for male infertility. Yamanaka, et al. (1998) Direct effects of Chinese herbal medicine "hachuekkito" on sperm movement. Nippon Hinyokika Gakkai Zasshi, 89(7):641-6 Jul (ISSN: 0021-5287).
  • Shan Zhu Yu enhances sperm motility: The effects of a Chinese herb, Cornus officinalis, on the motility of human sperm was studied. An aqueous extract was prepared from the dried fruits of the herb and used in this study. The crude extract at a final concentration of 0.5 microgram/micro liter in phosphate buffered saline (pH 7.4) increased sperm motility from 25.8 +/- 7.7% to 42.8 +/- 10.3% (i.e. 68% increase, n = 7), as determined by the computer-aided-sperm-analysis (CASA) method. The crude extract was fractionated by high-performance liquid chromatography (HPLC) into four fractions: C1, C2, C3 and C4. Their effects on sperm motility were further studied by CASA. Only the C4 fraction showed substantial stimulatory effects on sperm motility. At a concentration of 5 ng/microliter, C4 increased the sperm motility from 15.7 +/- 3.8% to 34.5 +/- 6.4% (i.e. 120% increase, n = 6) by CASA and from 14.9 +/- 4.3 to 28.5 +/- 8.1 (i.e. 91% increase, n = 8) by transmembrane migration ratio (TMMR) method. This result suggests that C4 is the active component in Cornus officinalis that enhances sperm motility. Jeng et al. (1997) A substance isolated from Cornus officinalis enhances the motility of human sperm. Am J Chin Med; 25(3-4): 301-6 (ISSN: 0192-415X).
  • Gui Zhi Fu Ling Wan improves semen quality: Thirty-seven infertile patients with varicocele were treated with Guizhi-Fuling-Wan (7.5 g/day) for at least 3 months. Before and after the administration, semen qualities such as sperm concentration and motility were examined, and the varicocele was graded. A varicocele disappearance rate of 80% was obtained with 40 out of 50 varicocele, and improvement of sperm concentration and motility were found in 71.4% and 62.1% of patients, respectively. From these results, Guizhi-Fuling-Wan is considered to be effective for circulation disorders in varicocele as well as semen quality. Ishikawa et al. (1996) Effects of guizhi-fuling-wan on male infertility with varicocele. Am J Chin Med, 24(3-4):327-31 (ISSN: 0192-415X).
  • Chinese herbs improve semen quality: Eighty-two patients were randomly divided (according to the digital list) into the WM group (n = 20, treated with prednisone), the TCM group (n = 28, treated with ZYD) and the ICWM group (n = 34, treated with prednisone plus ZYD). The clinical effect, negative converting rate of antisperm antibody, changes of NO level in semen and various parameters of sperm motion before and after treatment were observed. The total effective rate in the ICWM group was 88.2%, that in the TCM group 75.0% and in the WM group 65.0%. Significant difference was seen in the ICWM and TCM group before and after treatment in NO level, sperm motion parameters, including linear motion speed, linearity, propulsion, whip frequency, sperm vitality and mean moving angle, and quality of semen (P < 0.05 or P < 0.01). In the WM group, significant difference in comparison before and after treatment was seen in NO level, propulsion, whip frequency, mean moving angle and quality of semen, including vitality and survival rate (P 0.01). Combination of Chinese herbs and hormone could lower the NO level in semen and improve the quality of sperm. Yu et al. (2004) Clinical observation on effect of combination of zhuanyindan and hormone in treating male infertility with positive antisperm antibody. Zhongguo Zhong Xi Yi Jie He Za Zh, 24(3): 223-6.

Acupuncture and Chinese herbs helps women with PCOS have a baby

  • Chinese medicine improves pregnancy rate in women with PCOS: In this study, we explored the effect of acupoint catgut embedding combined with Chinese medicine for nourishing kidney and promoting blood circulation as well as improving the glucose and lipid levels and pregnancy rate in obese polycystic ovary syndrome (PCOS) patients with infertility. A total of 62 obese patients with PCOS were randomly divided into three groups, 21 of whom were treated with acupoint catgut embedding combined with Chinese medicine, another 21 with catgut embedding therapy, and 20 only with Chinese medicine. The study has shown that acupoint catgut embedding therapy combined with Chinese medicine for nourishing the kidneys and promoting blood circulation and improving blood glucose and lipid levels as well as the pregnancy rate in obese PCOS patients with infertility is useful. Qin et al. (2016) Effect of acupoint catgut embedding therapy combined with Chinese medicine for nourishing the kidneys and promoting blood circulation and improving blood glucose and lipid levels as well as the pregnancy rate in obese PCOS patients with infertility. Exp Ther Med, Nov;12(5):2909-2914.
  • Acupuncture regulates the menstrual cycle, reduces a woman's BMI and Luteal Hormone levels thereby improving PCOS: A systematic review and meta-analysis was conducted of RCTs that compared either acupuncture with no/sham (placebo) acupuncture or a certain therapy with acupuncture added in the treatment of PCOS. Measures of treatment effectiveness were the pooled odds ratios (OR) for women with PCOS having acupuncture compared with women in the control group for the recovery of menstrual cycles, standardized mean difference (SMD) for body mass index (BMI), fasting insulin (FINS), fasting plasma glucose (FPG), luteinizing hormone (LH), follicle stimulating hormone (FSH), and the ratio of LH/FSH. A total of nine RCTs (531 women) met criteria for inclusion into the systematic review. Using the random effects model, pooling of the effect estimates from all RCTs showed recovery of menstrual cycles (OR = 0.20, 95% CI: 0.09 to 0.41, P 0.01), BMI (SMD = -0.63, 95% CI: -1.04 to -0.21, P=0.04), and LH (SMD = -0.39, 95% CI: -0.65 to -0.12, P < 0.01) which favored the acupuncture group. No significant differences were observed for FINS, FPG, FSH and the ratio of LH/FSH between acupuncture and control groups (P 0.05). Acupuncture appears to significantly improve the recovery of the menstrual cycles and decrease the levels of BMI and LH in women with PCOS. Qu, et al. The effects of acupuncture on polycystic ovary syndrome: A systematic review and meta-analysis. European Journal of Integrative Medicine, Volume 8, Issue 1, February 2016, 12–18.
  • Acupuncture regulates ovulation: Prospective, longitudinal non-randomized clinical study investigating the effect of acupuncture on ovulation in 24 women with PCOS and oligo-/amenorrhea. Electro-acupuncture induced regular ovulation in 38% of women. In addition, acupuncture influenced neruoendocrine and endocrine parameters indicative of PCOS, such as LH/FSH ratios, mean testosterone concentrations, and beta-endorphin concentrations. Stener-Victorin, et al. (2000) Effects of electro-acupuncture on anovulation in women with polycystic ovary syndrome Acta Obstet Gynecol Scand, Mar;79(3): 180-8.
  • Acupuncture increases pregnancy rate in women with PCOS undergoing IVF: We searched a total of 15 databases through October 2015. The participants were women with PCOS (diagnosed using the Rotterdam criteria) undergoing IVF or ICSI. Eligible trials were those with intervention groups receiving manual acupuncture (MA) or electroacupuncture (EA), and control groups receiving sham acupuncture, no treatment or other treatments. Outcomes included the clinical pregnancy rate (CPR), live birth rate (LBR), ongoing pregnancy rate (OPR) and incidence of ovarian hyperstimulation syndrome (OHSS) and adverse events (AEs). For statistical pooling, the risk ratio (RR) and its 95% (confidence interval) CI was calculated using a random effects model. Four RCTs including 430 participants were selected. All trials compared acupuncture (MA/EA) against no treatment. Acupuncture significantly increased the CPR (RR 1.33, 95% CI 1.03 to 1.71) and OPR (RR 2.03, 95% CI 1.08 to 3.81) and decreased the risk of OHSS (RR 0.63, 95% CI 0.42 to 0.94); however, there was no significant difference in the LBR (RR 1.61, 95% CI 0.73 to 3.58). None of the RCTs reported on AEs. Acupuncture may increase the CPR and OPR and decrease the risk of OHSS in women with PCOS undergoing IVF or ICSI. Further studies are needed to confirm the efficacy and safety of acupuncture as an adjunct to assisted reproductive technology in this particular population. Jo, et al. (2017). Effectiveness of acupuncture in women with polycystic ovarian syndrome undergoing in vitro fertilisation or intracytoplasmic sperm injection: a systematic review and meta-analysis. Acupunct Med. pii: acupmed-2016-011163. doi: 10.1136/acupmed-2016-011163.
  • Acupuncture regulates fertility hormones without side effects: Following a complete gynecologic-endocrinologic workup, 45 itfertile women sufering from oligoamenorrhea (n = 27) or luteal insuficiency (n = 18) were treated with auricular acupuncture. Results were compared to those of 4.5 women who received hormone treatment. Both groups were matchedfor age, duration of infertility, body mass index, previous pregnancies, menstrual cycle and tuba1 patency. Women treated with acupuncture had 22 pregnancies, 11 after acupuncture, four spontaneously, and seven after appropriate medication. Women treated with homiones had 20 pregnancies, five spontaneously, and 15 in response to therapy. Four women ofeachgroup had abortions. Endometriosis (normal menstrual cycles) was seen in 35% (38%) of the women of each group who failed to respond to therapy with pregnancy. Only 4% of the women who responded to acupuncture or hormone treatment with a pregnancy had endometriosis, and 7% had normal cycles. In addition, women who continued to be infertile after hormone therapy had higher body mass indices and testosterone values than the therapy responders from this group. Women who became pregnant after acupuncture suflered more often from menstrual abnormalities and heal insuflciency with lower estrogen, thyrotropin (TSH) and dehydroepiandrosterone sulfate (DHEAS) concentrations than the women who achieved pregnancy after hormone treatment. Although the pregnancy rate was similar for both groups, eumenorrheic women treated with acupuncture had adnexitis, endometriosis, out-ofphase endometria and reduced postcoital tests more often than those receiving hormones. Twelve of the 27 women (44%) with menstrual irregularities remained infertile after therapy with acupuncture compared to 15 of the 27 (56%) controls treated with hormones, even though hormone disorders were more pronounced in the acupuncture group. Side-eflects were observed only during hormone treatment. Various disorders ofthe autonomic nervous system normalized during acupuncture. Based on our data, auricular acupuncture seems to ofer a valuable alternative therapy for female infertility due to hormone disorders. Gerhard et al. (1992) Auricular Acupuncture in the Treatment of Female Infertility. Gynecol. Endocrinol. 6, 171-181.
  • Acupuncture improves sensitivity to insulin in females with PCOS: Polycystic ovary syndrome (PCOS) is a complex endocrine and metabolic disorder associated with ovulatory dysfunction, hyperandrogenism, abdominal obesity, and insulin resistance. Pharmacotherapy is often unsatisfactory. At age 10 wk, PCOS rats were randomly divided into three groups; PCOS, PCOS EA, and PCOS exercise. PCOS EA rats received 2-Hz EA (evoking muscle twitches) three times/wk during 4–5 wk. PCOS exercise rats had free access to a running wheel for 4–5 wk. EA and exercise improved insulin sensitivity, measured by clamp, in PCOS rats. Exercise also reduced adiposity, visceral adipocyte size, and plasma leptin. EA increased plasma IGF-I. Real-time RT-PCR revealed increased expression of leptin and IL-6 and decreased expression of uncoupling protein 2 in visceral adipose tissue of PCOS rats compared with controls. EA restored the expression of leptin and uncoupling protein 2, whereas exercise normalized adipose tissue leptin and IL-6 expression in PCOS rats. Thus, EA and exercise ameliorate insulin resistance in rats with PCOS. This effect may involve regulation of adipose tissue metabolism and production because EA and exercise each partly restore divergent adipose tissue gene expression associated with insulin resistance, obesity, and inflammation. In contrast to exercise, EA improves insulin sensitivity and modulates adipose tissue gene expression without influencing adipose tissue mass and cellularity. Mannerås et al. (2011) Low-Frequency Electro-Acupuncture and Physical Exercise Improve Metabolic Disturbances and Modulate Gene Expression in Adipose Tissue in Rats with Dihydrotestosterone-Induced Polycystic Ovary Syndrome. Endocrinology 149: 3559–3568, 2008.
  • Wen Jing Tang improves PCOS: The objective of this study was to investigate the effects of switching therapy to Wen-jing-tang (Unkei-to) from previous selected herbal preparations on endocrine levels and induction of ovulation in women with polycystic ovary syndrome (PCOS). Sixty-four anovulatory women diagnosed with PCOS were enrolled in the study. After Kampo diagnosis, subjects received matched Kampo preparations (43 cases: Dang-gui-shao-yao-san, 21 cases: Gui-zhi-fu-ling-wan) selected by the matching theory of eight-principle pattern identification and Kampo diagnosis based on concepts of the qi, blood, and fluids as the physiologic activity. Fifty-four women who failed to ovulate after an 8-week treatment were randomly allocated to continuation of treatment with the preceding Kampo prescription (continuation group, n = 27) or treatment with Wen-jing- tang (switching group, n = 27). Plasma FSH, LH and estradiol levels were measured and ovulation rates were determined at the beginning and after an 8-week treatment with the preceding Kampo prescription, as well as after the subsequent 8-week treatment with the same preparation or Wen-jing-tang. No decrease in mean plasma LH level was observed in the 54 women who failed to ovulate among the 64 treated with a Kampo preparation. After the 8-week treatment with Wen-jing-tang, plasma LH levels were decreased by 58.2% (p 0.0001) and 49.4% (p = 0.0005) in the groups switched from Dang-gui-shao-yao-san and Gui-zhi-fu-ling-wan, respectively. In the group switched from Dang-gui-shao-yao- san, a tendency towards increase in plasma estradiol level was observed (1.51-fold, p = 0.055), which was significant compared with that in the group switched from Gui-zhi-fu-ling-wan (p = 0.032). The ovulation rate with switching of treatment to Wen- jingtang was significantly higher (59.3%) than that with continued use of the same preparation (7.4%, p = 0.0036). This study confirmed that Wen-jing-tang was effective in improving endocrine condition in the treatment of disturbances of ovulation in patients with PCOS without taking eight principle pattern identification into consideration. This finding indicates that Wen-jing-tang is appropriate for use in treating PCOS in women with various constitutions (as determined by the matching theory of eight-principle pattern identification) in clinical practice and may prove to be a potent therapeutic agent with a wide therapeutic spectrum. Ushiroyama, et al. (2006) Effects of Switching to Wen-Jing-Tang (Unkei-To) from Preceding Herbal Preparations Selected by Eight-Principle Pattern Identification on Endocrinological Status and Ovulatory Induction in Women with Polycystic Ovary Syndrome. The American Journal of Chinese Medicine, Vol. 34, No. 2, 177–187.
  • Acupuncture exerts long lasting benefits in women with PCOS: This review describes the aetiology and pathogenesis of polycystic ovary syndrome (PCOS) and evaluates the use of acupuncture to prevent and reduce symptoms related with PCOS. PCOS is the most common female endocrine disorder and it is strongly associated with hyperandrogenism, ovulatory dysfunction and obesity. PCOS increases the risk for metabolic disturbances such as hyperinsulinaemia and insulin resistance, which can lead to type 2 diabetes, hypertension and an increased likelihood of developing cardiovascular risk factors and impaired mental health later in life. Despite extensive research, little is known about the aetiology of PCOS. The syndrome is associated with peripheral and central factors that influence sympathetic nerve activity. Thus, the sympathetic nervous system may be an important factor in the development and maintenance of PCOS. Many women with PCOS require prolonged treatment. Current pharmacological approaches are effective but have adverse effects. Therefore, nonpharmacological treatment strategies need to be evaluated. Clearly, acupuncture can affect PCOS via modulation of endogenous regulatory systems, including the sympathetic nervous system, the endocrine and the neuroendocrine system. Experimental observations in rat models of steroid-induced polycystic ovaries and clinical data from studies in women with PCOS suggest that acupuncture exert long-lasting beneficial effects on metabolic and endocrine systems and ovulation. Stener-Victorin, et al. (2007) Acupuncture in Polycystic Ovary Syndrome: Current Experimental and Clinical Evidence. Journal of Neuroendocrinology 20 (3), 290–298. doi: 10.1111/j.1365-2826.2007.01634.x.
  • Acupuncture increases blood flow to the uterus in females with PCOS: Maintenance of ovarian blood flow (OBF) is suggested to be important for regular ovulation in women with polycystic ovaries (PCO). The purpose of the present study was to investigate whether electro-acupuncture (EA) of different frequencies and intensities can improve the OBF of anaesthetized rat in the animal model of PCO. PCO was experimentally induced by a single intramuscular (i.m.) injection of estradiol valerate (EV) in rats. Control rats were given i.m. injection of oil. The involvement of the two ovarian sympathetic nerves; superior ovarian nerve (SON) and plexus ovarian nerve (OPN), in OBF responses was elucidated by severance of SON and OPN in both control and PCO rats. How systemic circulatory changes affect OBF was evaluated by continuous recording of the blood pressure. OBF was measured on the surface of the ovary-using laser Doppler flowmetry. Acupuncture needles were inserted bilaterally into the abdominal and hind limb muscles and connected to an electrical stimulator. Two frequencies – 2 Hz (low) and 80 Hz (high) – with three different intensities – 1.5, 3, and 6 mA – were applied for 35 s. Low-frequency EA at intensities of 3 and 6 mA elicited significant increases in OBF in the Control group compared to baseline. In the PCO group the increases in OBF were significant only when stimulating with low-frequency EA at 6 mA. After severance of the ovarian sympathetic nerves, the increased response of OBF that had been induced by low-frequency EA in both the Control and PCO group was abolished, indicating that the OBF response is mediated via the ovarian sympathetic nerves. Highfrequency EA at 6 mA significantly decreased OBF and mean arterial blood pressure (MAP) in the Control group compared to baseline. In the PCO group, the same stimulation produced similar decreases in MAP, but not in OBF. Low-frequency EA stimulation with a strong intensity (6 mA) increases OBF in rats with steroid-induced PCO whereas less strong intensity (3 mA) induces similar changes in control rats. Severance of the ovarian sympathetic nerves, abolish this OBF increase in both study groups, which suggests that the responses of OBF to EA are mediated via the ovarian sympathetic nerves. Stener-Victorin et al. (2004) Effect of electro-acupuncture stimulation of different frequencies and intensities on ovarian blood flow in anaesthetized rats with steroid-induced polycystic ovaries. Reproductive Biology and Endocrinology, 2.
  • Acupuncture helps with weight loss than just dieting alone: Electric Acupuncture (EA) was applied to 20 females who were 41.45 ± 4.71 years old and had a body mass index of 36.00± 2.66; and a diet program was applied to 20 females who were 42.30 ± 4.35 years old and had a body mass index of 34.90 ± 3.21. There was a 4.5% weight reduction in the patients with EA application, whereas patients on diet restriction had a 3.1% weight reduction. A decrease of loss of body weight was observed in the EA group (p 0.000) when compared against the diet restricted group. A decrease of serum leptin levels (p 0.000) and an increase in the serum BE (p 0.05) levels were observed in the EA group compared to the diet restricted group. In this study, reduced serum leptin levels paralleling to weight loss were observed in the EA group. Furthermore, it is thought that in the EA applied group, increasing serum BE level probably enhanced the lipolitic activity which may have caused weight loss in obese people by mobilizing energy stores. It may be considered that the EA application with diet restriction in obesity treatment is more effective than the diet restriction alone. Tugrul Cabioglu et al. (2006) Changes in Serum Leptin and Beta Endorphin Levels with Weight Loss by Electroacupuncture and Diet Restriction in Obesity Treatment. The American Journal of Chinese Medicine, Vol. 34, No. 1, 1–11.
  • Acupuncture better than exercise for women with PCOS: We randomized 84 women with PCOS, aged 18–37 yr, to 16 wk of low-frequency EA, physical exercise, or no intervention. The primary outcome measure changes in the concentration of total testosterone (T) at week 16 determined by gas and liquid chromatography-mass spectrometry was analyzed by intention to treat. Secondary outcome measures were changes in menstrual frequency; concentrations of androgens, estrogens, androgen precursors, and glucuronidated androgen metabolites; and acne and hirsutism. Outcomes were assessed at baseline, after 16 wk of intervention, and after a 16-wk follow-up. After 16 wk of intervention, circulating T decreased by 25%, androsterone glucuronide by 30%, and androstane-3,17-diol-3-glucuronide b y28% in the EA group (P 0.038, 0.030, and 0.047, respectively vs. exercise); menstrual frequency increased to 0.69/month from 0.28 at baseline in the EA group (P 0.018 vs. exercise). After the 16-wk follow-up, the acne score decreased by 32% in the EA group (P 0.006 vs. exercise). Both EA and exercise improved menstrual frequency and decreased the levels of several sex steroids at week 16 and at the 16-wk follow-up compared with no intervention. Low-frequency EA and physical exercise improved hyperandrogenism and menstrual frequency more effectively than no intervention in women with PCOS. Low-frequency EA was superior to physical exercise. Jedel et al. (2011) Impact of electro-acupuncture and physical exercise on hyperandrogenism and oligo/amenorrhea in women with polycystic ovary syndrome: a randomized controlled trial. Am J Physiol Endocrinol Metab 300: E37–E45.
  • Chinese herbs reduce testosterone levels and induce ovulation: To observe the effect of tonifying Kidney herbs (TKH) in pituitary, ovary, adrenal gland of androgen sterilized rats (ASR). ASR model was established by injecting testosterone propionate subcutaneously to SD female rats of 9 days age. Morphological and hormonal change of pituitary, ovary and adrenal gland in rats of 100-107 days old before and after feeding TKH extract were observed by light and electron microscope, cell culture immunohistochemical studies and radioimmuno-assay. In the ASR groups, there were intracytopiasmic lipid drops, autophagy, vacuole, granulolysis of pituitary gland. There were anovulation apparently and increased the amount of lipid drops in cytoplasm of interstitial glandular cell of ovary. The fatty drops of the reticular zone of adrenal gland decreased, the number of AGNOR (P 0.01) and PCNA (P 0.01) increased significantly. The levels of FSH, LH (P 0.05-0.005) lowered, but the levels of DHA, T (P 0.01, 0.05, 0.001) were raised significantly. Morphological and hormonal change of all RSA returned to normal range after the treatment. The hyperandrogenemia were disturbed by the function of sex gland axis and adrenal in female rats of 9 days old and played an important role in pathogenesis of ASR, the TKH reduced the levels of androgen and induced ovulation through sex gland axis and adrenal level and multi-organ regulation. Gui et al. (1997) Experimental study of effect on tonifying kidney herbs in pituitary ovary adrenal gland of androgen sterilized rats. Chung Kuo Chung Hsi I Chieh Ho Tsa Chih, 17(12):735-8 (ISSN: 1003-5370).

Acupuncture enhances the success of IVF

  • Acupuncture increases pregnancy rate in IVF: The purpose of this study was to determine if there are benefits of standard acupuncture compared to sham acupuncture as an adjunct to IVF. A randomized, controlled, double-blind, crossover pilot trial was performed using a needle-like device (sham acupuncture) as a control. Approval from GAMC’s Investigational Review Board was acquired. Inclusion criteria were women aged 18 to 42 years with a history of failed IVF cycle(s); day 3 FSH 20 IU/ml; the presence of both ovaries; and a normal uterine cavity. Exclusion criteria was Kruger morphology 4%. Seventeen subjects were enrolled and seven subjects completed both arms of the study. The mean age was 36.2 years (range 28–41 years). The mean Day 3 FSH6.8 IU (range 3–13 IU). There were four ongoing pregnancies after the first cycle, equally distributed. Our study shows a significantly lower amount of gonadotropins used when IVF is combined with standard acupuncture. A 70% pregnancy rate was also achieved with standard acupuncture and IVF, compared to 25%. Larger prospective trials are necessary. Quintero et al. (2004) A Randomized, Controlled, Double-Blind, Cross-Over Study Evaluating Acupuncture as an Adjunct to IVF. Glendale Adventist Medical Center (GAMC) and the Eastern Center for Complementary Medicine. Fertility & Sterility; Vol. 81, Suppl. 3.
  • Acupuncture normalises cortisol and prolactin levels during IVF: Sixty-seven reproductive-age infertile women undergoing IVF. Blood samples were obtained from all consenting new infertility patients and serum CORT and serum PRL were obtained prospectively. Patients were grouped as controls (IVF with no Ac) and treated (IVF with Ac) according to acupuncture protocols derived from randomized controlled trials. Serum levels of CORT and PRL were measured and synchronized with medication stimulation days of the IVF cycle (e.g., day 2 of stimulation, day 3, etc). Reproductive outcomes were collected according to Society for Assisted Reproductive Technology protocols, and results were compared between controls and those patients treated with Ac. CORT levels in Ac group were significantly higher on IVF medication days 7, 8, 9, 11, 12, and 13 compared with controls. PRL levels in the Ac group were significantly higher on IVF medication days 5, 6, 7, and 8 compared with controls. In this study, there appears to be a beneficial regulation of CORT and PRL in the Ac group during the medication phase of the IVF treatment with a trend toward more normal fertile cycle dynamics. Magarelli et al. (2009) Changes in serum cortisol and prolactin associated with acupuncture during controlled ovarian hyperstimulation in women undergoing in vitro fertilization-embryo transfer treatment. Fertil Steril; 92:1870–9. doi:10.1016/j.fertnstert.2008.10.067.
  • Acupuncture improves pregnancy rates in IVF: 160 patients who were undergoing ART and who had good quality embryos were divided into the following two groups through random selection: embryo transfer with acupuncture (n =80) and embryo transfer without acupuncture (n = 80). Acupuncture was performed in 80 patients 25 minutes before and after embryo transfer. In the control group, embryos were transferred without any supportive therapy. Clinical pregnancy was defined as the presence of a fetal sac during an ultrasound examination 6 weeks after embryo transfer. Clinical pregnancies were documented in 34 of 80 patients (42.5%) in the acupuncture group, whereas pregnancy rate was only 26.3% (21 out of 80 patients) in the control group. Acupuncture seems to be a useful tool for improving pregnancy rate after ART. Paulus, et al. (2002) Influence of acupuncture on the pregnancy rate in patients who undergo assisted reproduction therapy. Fertility and Sterility; Vol. 77, No. 4.
  • Acupuncture improves ovarian reserve and pregnancy rate in IVF: A total of 63 patients of DOR who received treatment of IVF/intracytoplasmic sperm injection (ICSI) were randomly divided into an observation group (30 cases) and a control group (33 cases). The patients in the observation group were treated with "menstrual cycle-based acupuncture therapy". The syndrome differentiation and treatment were given based on different phases of menstruation. Shiqizhui (EX-B 8) and Mingmen (GV 4) were selected during menstrual phase, Shenshu (BL 23), Geshu (BL 17), Sanyinjiao (SP 6) and Taixi (KI 3) were selected after menstruation, Qihai (CV 6), Guanyuan (CV 4), Zigong (EX-CA 1), Zusanli (ST 36) were selected during ovulatory period, Qihai (CV 6), Guanyuan (CV 4), Yanglingquan (GB 34), Taichong (LR 3) were selected before menstruation. The acupuncture was given twice a week until second menstrual cycle of oocyte retrieval. The total times of acupuncture was (15 ± 2). After acupuncture, patients were treated with IVF-ET. The patients in the control group were treated with IVF-ET but no acupuncture. The indices of ovarian reserve function, including basic follicle-stimulating hormone (FSH), estradiol (E2), antral follicle count (AFC), number of retrieved oocytes, number of fertilization and number of high quality embryo, were compared and analyzed before and after acupuncture in the observation group. The differences of outcomes of IVF-ET, including the cycle cancellation rate, implantation rate, the clinical pregnancy rate, were compared between the two groups. Compared before acupuncture, the E2, AFC, number of retrieved oocytes, number of high quality embrgo and number of fertilization were all increased after acupuncture in the observation group (all P<0. 05). Compared with the control group, levels of the E2, the number of retrieved oocytes, number of fertilization and number of high quality embryo were all increased in the observation group (all P 0.05). Also, the implantation rate, the clinical pregnancy rate were improved (both P 0.01) and cycle cancellation rate was reduced (P 0.01). The "menstrual cycle-based acupuncture therapy" can effectively improve the ovarian reserve function in DOR patients, leading to an improved clinical pregnancy rate of IVF-ET. Zhou, et al. (2016) Effects of "menstrual cycle-based acupuncture therapy" on IVF-ET in patients with decline in ovarian reserve. Zhongguo Zhen Jiu, 36 (1): 25-8.
  • Acupuncture and moxibustion improve pregnancy rates in IVF when embryo implantation has failed: A prospective, randomised controlled clinical trial was conducted with 84 infertile patients who had had at least two unsuccessful attempts of IVF. The patients were randomised in three groups: control (n=28), sham (n=28) and acupuncture (n=28). The sample size was calculated by assuming a pregnancy rate of 10% when embryo implantation had failed. The pregnancy rates of the current IVF cycle were evaluated by measurement of blood ß human chorionic gonadotrophin (ßhCG) and subsequent transvaginal ultrasound. Acupuncture was performed on the first and seventh day of ovulation induction, on the day before ovarian puncture and on the day after embryo transfer. In the acupuncture group, patients were treated with moxibustion at nine acupuncture points (BL18, BL22, BL23, BL52, CV3, CV4, CV5, CV7, GV4) and needling at 12 points. In the sham group needles were inserted in eight areas that did not correspond to known acupuncture points. Results The clinical pregnancy rate in the acupuncture group was significantly higher than that in the control and sham groups (35.7% vs 7.1% vs 10.7%; p=0.0169). Conclusions In this study, acupuncture and moxibustion increased pregnancy rates when used as an adjuvant treatment in women undergoing IVF, when embryo implantation had failed. Isoyama et al. (2013) Influence of acupuncture on the outcomes of in vitro fertilisation when embryo implantation has failed: a prospective randomised controlled clinical trial. Acupunct Med; 31:157–161. doi:10.1136/acupmed-2012-010269.
  • Acupuncture prevents and treats OHSS: This study aimed to elucidate the effect of electroacupuncture treatment on preventing early ovarian hyperstimulation syndrome (OHSS) and the potential mechanisms involved using an induced rat model. The ovarian response was examined by measuring ovary weight, vascular permeability, levels of inflammation (interleukin-6), tumour necrosis factor alpha, chemokine ligand 2 (also known as monocyte chemoactic protein 1), vascular endothelial growth factor and hormone concentrations (oestradiol, progesterone, testosterone and prolactin). Sprague-Dawley female rats underwent ovarian stimulation to induce OHSS. Hyperstimulated rats received consecutive electroacupuncture treatment from 3 days before the beginning of pregnant mare serum gonadotrophin treatment or the time point of pregnant mare serum gonadotrophin treatment respectively, and last until 3 days after HCG administration. Electroacupuncture treatment reduced ovary weight and vascular permeability in hyperstimulated rats. Electroacupuncture treatment also reduced the levels of serum steroid hormones (progesterone and testosterone), inflammatory cytokines (interleukin-6, tumour necrosis factor alpha and monocyte chemotactic protein 1 and vascular endothelial growth factor in hyperstimulated rats. The results indicate that electroacupuncture can modulate endocrine hormone secretion and affect the secretion of inflammatory cytokines and vascular endothelial growth factor, and thus prevent the progress of OHSS. Electroacupuncture may provide a simple and effective method for the prevention and treatment of OHSS. Chen et al. (2016) Electroacupuncture decreases the progression of ovarian hyperstimulation syndrome in a rat model. Reprod Biomed Online; 32(5):538-44. doi: 10.1016/j.rbmo.2016.02.006.
  • Acupuncture improves the pregnancy rate in IVF/ICSI: Study with a total of 111 cycles of patients who underwent assisted reproduction techniques: in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) from June/2005 to January/2007: 52 cycles with acupuncture and 59 cycles without acupuncture. Acupuncture was performed, in specific points of the body including the ear, immediately before and after the embryo transfer procedure and the needles were retained for 30 minutes per session. The embryo transfer was carried out under ultrasound guidance and luteal phase support was given by transvaginal progesterone administration (Utrogestan) and intramuscular progesterone. Outcome measure was clinical pregnancy rate. The clinical pregnancy rate per cycle was observed in 27 of 52 (51.9%) patients in the acupuncture group and 21 of 59 (35.6%) patients in the control group (P¼0,083). The mean age was 36.1  6.1 years in the control group and 36.4 5.4 years in the acupuncture group (P¼0.785). The mean number of embryo transferred was 3.3 1.4 in the control group and 3.6  1.4 in the acupuncture group (P¼0.462). The technique of embryo transfer was 5 cycles of IVF and 54 cycles of ICSI in the control group and 5 cycles IVF and 47 cycles of ICSI in the acupuncture group (P¼1.000). Both groups did not show statistics difference in the mean age, number of embryo transferred and the technique procedure. Although there was a higher pregnancy rate in the acupuncture group,this difference was not statistically significant, probably because of the small number of patients in both group. Acupuncture seems to be an important coadjuvant in the treatment of infertility with IVF or ICSI, and further research. Teshima, et al. (2007) The effect of acupuncture in assisted reproduction techniques. Fertility and Sterility, Vol. 88, S329–S330.
  • Acupuncture improves pregnancy rates: The Acupuncture Group consisted of 49 patients who received acupuncture on-site before and after embryo transfer in 2007. The treatment did not follow the Paulus protocol. The Control Group were 212 patients with no acupuncture undergoing IVF cycles in the same time period. The data was subdivided by SART age classifications to determine if acupuncture differentially benefitted certain age groups. Clinical Pregnancy Rate (CPR) was defined as the presence of fetal cardiac activity. Loss Rate was the percentage of pregnancies that did not proceed from a positive hCG to a clinical pregnancy. Data were analyzed using the unpaired t-test and Fisher’s exact test, with significance defined as P 0.05. Patients with a positive hCG were significantly higher in the Acupuncture Group for women less than 35 years old (63.3% vs.43.2%, p ¼ 0.048). The Acupuncture Group also had a higher CPR in the under 35 category (60.0% vs. 34.6%, p ¼ 0.01). There were no differences in the other age groups. Youran et al. (2008) Acupuncture performed before and after embryo transfer improves pregnancy rates. Fertility and Sterility, Vol. 90, S240–S241.
  • Acupuncture reduces stress and improves pregnancy rates in IVF/ICSI: 57 infertile patients undergoing IVF or IVF/ICSI. Patients were undergoing Embryo Transfer with or without acupuncture as part of their standard clinical care. Main outcome measure(s): Perceive Stress Scale scores, pregnancy rates. Women who received this acupuncture regimen achieved pregnancy 64.7%, whereas those without acupuncture achieved pregnancy 42.5%. When stratified by donor recipient status, only nondonor recipients potentially had an improvement with acupuncture (35.5% without acupuncture vs. 55.6% with acupuncture). Those who received this acupuncture regimen had lower stress scores both pre-ET and post-ET compared to those who did not. Those with decreased their perceived stress scores compared to baseline had higher pregnancy rates than those who did not demonstrate this decrease, regardless of acupuncture status. The acupuncture regimen was associated with less stress both before and after embryo transfer, and it possibly improved pregnancy rates. Balk, et al. (2010) The relationship between perceived stress, acupuncture, and pregnancy rates among IVF patients: A pilot study. Complementary Therapies in Clinical Practice, 16, 154–157.
  • Acupuncture improves live birth rate in women with a high FSH in IVF: Patients planning to undergo IVF who met inclusion/exclusion criteria (age less 40 years old, FSH less 10mIU/mL, 3 prior failed IVF attempts, acupuncture naive) were randomly assigned to an acupuncture or sham treatment group. Treatment sessions occurred before gonadotropin start, before oocyte retrieval, the day before embryo transfer, and the day after embryo transfer. Acupuncture was performed using manual manipulation at 6 to 10 points depending on the timing of the treatment. Sham treated patients had needles placed in non-meridian points at a shallow depth. Patients were also given a questionnaire to guess their group assignment. Data was analyzed using chi-squared for dichotomous outcome variables (e.g. pregnancy rate) and t-tests for continuous outcomes (e.g. age). Sixty qualified patients were randomly assigned into either acupuncture (n¼31) or sham-control (n¼29) groups, with mean age of 32.4 and 33.2 respectively. 43 patients completed the study. The cancellation/drop-out rate was 29% in the acupuncture group (n¼9) and 27.6% in the control group (n¼8) (similar to cycle cancellation rate for the main recruitment center during this time period). There was no significant difference between groups regarding age or FSH. There was no significant difference in outcomes between acupuncture and control groups (clinical pregnancy rates per transfer 57.1% vs. 52.4%). There was a trend towards a higher delivery rate per transfer in the acupuncture group (54.5% vs. 42.9%). Further subgroup analysis by FSH found a higher pregnancy rate with acupuncture in patient whose FSH was higher than the mean (7.0) (83.3 vs 33.3. P¼0.079). Almost all the patients in both groups believed they were in the true acupuncture group. It is feasible to conduct a randomized, blinded, sham control trial to study the impact of acupuncture on IVF success rates. Preliminary data shows no significant difference between acupuncture and sham treatment groups. Acupuncture was associated with a trend toward a higher delivery rate per transfer especially in those patients with an FSH level higher than the mean. Udoff, et at (2014) The effect of acupuncture on pregnancy outcomes in in-vitro fertilization (IVF): a randomized controlled trial. Fertility and Sterility, Vol. 102, Issue 3, e333.
  • Acupuncture improves clinical pregnancy rates of IVF: Patients (n 258) who had been scheduled for embryo transfer (ET), signed informed consent and were randomly assigned to one of 5 study treatment regimens; needle acupuncture (AC; n 53), laser acupuncture (LZ AC; n 53), sham laser acupuncture (placebo)(LZ sham; n 52), relaxation (RX; n 50), or no intervention treatment (NT; n 50). All treatments were administered 25 minutes before ET and immediately after ET. The patient and acupuncturist were unaware of whether the laser system was active which allowed for a double-blind control group for the laser acupuncture treatment. Comparisons of various parameters between groups were conducted by 2 tests and one-way ANOVAs. Multinomial logistic regression analysis was used to control for the potentially confounding effects of day of embryo transfer (day 3 vs.5) and number of embryos transferred which are known to relate to IVF outcome, to further analyze the impact of adjunct treatment regimens on implantation and pregnancy rates. Probability of P 0.05 was considered to be statistically significant. No differences in terms of cycle type, day of embryo transfer, or physician performing transfer were found between treatment groups. Neither day of transfer (p 0.079) or egg number (P 0.082) were significant independent predictors of implantation or conception when interactions between parameters were considered in all 5 groups. All acupuncture treatments were well tolerated. Conception and implantation rates were highest with traditional needle acupuncture. IVF treatment outcomes did not difference between patients treated with laser or sham laser acupuncture. This study did not have the statistical power to detect treatment differences in pregnancy rates between needle acupuncture and no treatment (i.e. at least 200 subjects are needed to detect differences in CP rates of 54.7 and 44% with 80% power) which may be due to sample size, transfer of embryos of varying quality and variations in stimulation protocols. However, while not statistically significant, needle acupuncture produced a clinically significant effect (greater than 10% increase in clinical pregnancy rate) compared with relaxation or no treatment which warrants further investigation. Benson, et al. (2006) Impact of acupuncture before and after embryo transfer on the outcome of in vitro fertilization cycles: A prospective single blind randomized study. Fertility and Sterility, Vol. 86, Issue 3, S135.
  • Acupuncture improves the success rates of IVF/ICSI: Two hundred twenty-five infertile patients undergoing IVF/ICSI. In group I, 116 patients received luteal-phase acupuncture according to the principles of traditional Chinese medicine. In group II, 109 patients received placebo acupuncture. In group I, the clinical pregnancy rate and ongoing pregnancy rate (33.6% and 28.4%, respectively) were significantly higher than in group II (15.6% and 13.8%). Luteal-phase acupuncture has a positive effect on the outcome of IVF/ICSI. Dieterle, et al. (2006) Effect of acupuncture on the outcome of in vitro fertilization and intracytoplasmic sperm injection: a randomized, prospective, controlled clinical study. Fertility and Sterility Vol. 85, No. 5. doi:10.1016/j.fertnstert.2005.09.062.
  • Acupuncture thickens the uterus lining and enhances the effects of Sildenafil during IVF: To evaluate the combined effects of acupuncture and Sildenafil on endometrial thickness during IVF. Prospective self-controlled trial. Four infertility patients with prior IVF failures and an inability to achieve a uterine lining of R8 mm. A series of five acupuncture treatments applied at specific intervals during an IVF cycle. All other parameters were kept consistent with the respective patient’s prior cycle. All four subjects achieved endometrial lining thickness of >9mm following the administration of acupuncture, including one patient whose lining did not exceed 5 mm in a previous cycle. We also noted that endometrial thickness of most patients continued to increase post-hCG administration. Our pilot study is consistent with previous reports that acupuncture improves uterine lining measurements over previous cycles. Yu, et al. (2007) A Pilot Study Evaluating the Combination of Acupuncture with Sildenafilon Endometrial Thickness. Fertility and Sterility, Volume 87, Issue 4, Supplement 2, Page S23.
  • Acupuncture improves pregnancy rates in IVF: In this retrospective study, data was extracted from medical records of patients RE&I clinic & acupuncture clinics between January 2001 and November 2003. All patients completing an IVF cycle with transfer were included. One RE&I provided the IVF care and a consortium of acupuncturists overseen by the author provided the strict acupuncture protocols. PR per transfer were the endpoints measured. Data was analyzed by student’s t test and Multiregression with Wilcox ranking (MRW). Results: 147 patients were included in the study and of those 53 had Acupuncture (Ac) and 94 did not (Non-Ac group). Demographic data between these Ac and Non-Ac groups respectively indicated remarkable equity (Table 1). Fertility Factors also demonstrated equity and there were no differences in Diagnoses, IVF Protocols and type of Gonadatrophin protocols used. Factors that demonstrated significance were: Length of time infertile, Peak FSH, PI for total group without MRW; PI for MRW groups reversed this and finally average: Sperm Morphology, Peak E2, Peak P4 prior to HcG: and endometrial thickness. PR before Wilcox ranking were the same: 40% v 38%. MRW analysis revealed FSH, Length of time trying to get pregnant, Sperm Morphology and E2 levels as significant: 6.5, 4.1, 4.0 and 1.6 respectively. When the Ac group was modified (15 Ac patient dropped), PI was elevated from 1.76 to 1.94 resulting in a significant elevationcompared to the Non-Ac group, p 0.01. Also PR changed from 40% before to 53% after and this value was significantly greater than the Non-Ac group (38%), p 0.01. Conclusions: Significant increases in pregnancy outcomes were confirmed by this study and the data uniquely supported the advantage of acupuncture in patients with normal PI (prior studies were done on patient with PI 3). We also demonstrated that both acupuncture treatment protocols could be used together with a synergistic effect. Finally, this study is the first to demonstrate that the use of acupuncture in patients with poor prognoses (elevated Peak FSH, longer history of infertility, poor sperm morphology) can achieve similar pregnancy rates to normal prognosis patients. Magarelli, et al. (2004) Acupuncture & IVF Poor Responders: A Cure? Fertility & Sterility, Vol. 81, Suppl. 3, S20.
  • Acupuncture regulates fertility hormones, increases blood flow to the uterus and ovaries, regulates cytokines and reduces stress, anxiety and depression: To provide an overview of the use of acupuncture as an adjunct therapy for in vitro fertilization (IVF), including an evidence-based evaluation of its efficacy and safety and an examination of possible mechanisms of action. Literature review using PubMed, the Science Citation Index, The Cochrane Library (Database of Systematic Reviews and Central Register of Controlled Trials), the New England School of Acupuncture library databases, and a cross-referencing of published data, personal libraries, and Chinese medicine textbooks. Limited but supportive evidence from clinical trials and case series suggests that acupuncture may improve the success rate of IVF and the quality of life of patients undergoing IVF and that it is a safe adjunct therapy. However, this conclusion should be interpreted with caution because most studies reviewed had design limitations, and the acupuncture interventions employed often were not consistent with traditional Chinese medical principles. The reviewed literature suggests 4 possible mechanisms by which acupuncture could improve the outcome of IVF: modulating neuroendocrinological factors; increasing blood flow to the uterus and ovaries; modulating cytokines; and reducing stress, anxiety, and depression. Anderson, et al. (2007) In vitro fertilization and acupuncture: clinical efficacy and mechanistic basis. Altern Ther Health Med; 13(3): 38-48.
  • Acupuncture increases the pregnancy rate of IVF: A computer search was performed via several English and Chinese databases to identify journals relevant to the subject. The positive effect of acupuncture in the treatment of subfertility may be related to the central sympathetic inhibition by the endorphin system, the change in uterine blood flow and motility, and stress reduction. Acupuncture may help restore ovulation in patients with polycystic ovary syndrome, although there are not enough randomized studies to validate this. There is also no sufficient evidence supporting the role of acupuncture in male subfertility, as most of the studies are uncontrolled case reports or case series in which the sample sizes were small. Despite these deficiencies, acupuncture can be considered as an effective alternative for pain relief during oocyte retrieval in patients who cannot tolerate side effects of conscious sedation. The pregnancy rate of IVF treatment is significantly increased, especially when acupuncture is administered on the day of embryo transfer. Huang, et al. (2008) The role of acupuncture in the management of subfertility. Fertil Steril; 90:1–1.
  • Chinese medicine improves pregnancy rate after failed IVF: Sixty-seven patients were enrolled in this study and divided into two groups: a trial group with 35 patients and a control group with 32 patients. The trial group was given Chinese medicine for 3 months, then administered IVF-ET or awaited natural pregnancy. The control group was administered IVF-ET without Chinese medicine 3 months after the previous IVF-ET or natural pregnancy attempt. After treatment with TCM comprehensive therapy, seven patients in the treatment group became pregnant, while there were no successful conceptions in the control group. The difference in clinical pregnancy rate in the initial cycle and transfer cycle of IVF were significantly different (P 0.05). The trial group had a significantly higher conception rate than that of the control group (P 0.05). Chines medicine can promote the natural pregnancy rate in patients with previously failed IVF-ET. Chinese medicine could increase patients' fertilized egg number, fertilization rate, pregnancy rate, and clinical pregnancy rate after another IVF-ET treatment. Xu et al. (2015) Effect of traditional Chinese comprehensive therapy on gestation in patients with previously failed in vitro fertilization and embryo transfer. J Tradit Chin Med; 35(4): 428-433.
  • Chinese medicine increases IUI success rates: In the first study that measures the effectiveness of both herbs and acupuncture in combination with IUI infertility treatment, Dr. Shahar Lev-Ari and Keren Sela of TAU's Sackler Faculty of Medicine and the Tel Aviv Medical Center say that the results, which have been published in the European Journal of Integrative Medicine, show a significant increase in fertility when the therapies are administered side-by-side. In terms of both conception and take-home baby rates, the test group fared far better than the control group. Out of the 29 women in the test group, 65.5 percent conceived, and 41.4 percent delivered healthy babies. In the control group, only 39.4 percent conceived and 26.9 percent delivered. The vast difference in success rates is even more surprising when the age of the average participant was taken into account, Dr. Lev-Ari and Sela note. "The average age of the women in the study group was 39.4, while that of the control group was 37.1. Normally, the older the mother, the lower the pregnancy and delivery rates," they explain. Sela et al. (2011) Acupuncture and Chinese herbal treatment for women undergoing intrauterine insemination. European Journal of Integrative Medicine, Volume 3, Issue 2, e77–e81.
  • Acupuncture increases embryo transfer success rates in IVF: Increase of success rate for women undergoing embryo transfer by transcutaneous electrical acupoint stimulation. Group 3 had TEAS treatments: 24 hours before ET and 30 minutes after ET and had a clinical PR, embryos implantation rate, and live birth rate of (50.0%, 25.9%, and 42.0%, respectively), which was significantly higher than the control group. Zhang, et al. (2011) Increase of success rate for women undergoing embryo transfer by transcutaneous electrical acupoint stimulation: a prospective randomized placebo-controlled study. Fertility and Sterility Volume 96, Issue 4, 912-916.
  • Acupuncture increases live birth rate: A systematic review that looked at the effectiveness of acupuncture in the outcomes of assisted reproductive treatment (ART). A total of 13 randomised controlled trials were included of acupuncture for couples who were undergoing ART comparing acupuncture treatment alone or acupuncture with concurrent ART versus no treatment, placebo or sham acupuncture plus ART for the treatment of primary and secondary infertility. These found evidence of benefit when acupuncture is performed on the day of embryo transfer on the live birth rate (OR 1.86, 95%CI 1.29 to 2.77). The reviewers concluded that acupuncture performed on the day of embryo transfer shows a beneficial effect on the live birth rate. Cheong et al. (2008) Acupuncture and assisted conception. Cochrane Database of Systematic Reviews, Issue 4. Art. No.: CD006920. DOI: 10.1002/14651858.CD006920.pub2.
  • Acupuncture improves pregnancy rate in IVF: A systematic review that evaluated whether acupuncture improves rates of pregnancy and live birth when used as an adjuvant treatment to embryo transfer in women undergoing in vitro fertilisation. It included a total of 7 randomised controlled trials with 1,366 women Trials with sham acupuncture and no adjuvant treatment as controls were pooled for the primary analysis. Complementing the embryo transfer process with acupuncture was associated with significant and clinically relevant improvements in clinical pregnancy (OR 1.65, 95%CI 1.27 to 2.14; number needed to treat [NNT] 10, 95%CI 7 to 17), ongoing pregnancy (1.87, 1.40 to 2.49; NNT 9 (6 to 15); five trials), and live birth (1.91, 95%CI 1.39 to 2.64; NNT 9, 95%CI 6 to 17). The reviewers concluded that current preliminary evidence suggests that acupuncture given with embryo transfer improves rates of pregnancy and live birth among women undergoing in vitro fertilisation. Manheimer et al. (2008) Effects of acupuncture on rates of pregnancy and live birth among women undergoing in vitro fertilisation: systematic review and meta-analysis. BMJ; 336 (7643): 545-9.
  • Acupuncture increases the success rates of IVF: A randomised controlled trial that compared three acupuncture methods to evaluate which method is most effective for IVF. A total of 52 IVF patients were randomly assigned to receive traditional Chinese acupuncture plus electroacupuncture, acupuncture alone (control), or electroacupuncture alone (second control). Comparisons of IVF effectiveness rates were made for each method. All three acupuncture methods increased the success rate for IVF, and there was a marked increase with the combination treatment (81.8% success, which is twice the US average for IVF alone; p0.05). The researchers concluded that their results suggest the combination of acupuncture and electroacupuncture is a promising new technique for the treatment of infertility with a higher IVF success rate than that of either treatment alone. Kong et al. (2009) Acupuncture as an adjunct to in vitro fertilization: A randomized trial. Medical Acupuncture; 21: 179-82.
  • Acupuncture reduces stress during IVF: A randomised controlled trial to assess the efficacy of acupuncture on pregnancy rates in 150 women undergoing IVF. The women were allocated to acupuncture before and after embryo transfer, while the control group lay quietly. All the women then completed questionnaires on anxiety and optimism. There were no significant differences in pregnancy rates between the two groups, but the acupuncture patients reported significantly less anxiety post-transfer and reported feeling more optimistic about their cycle and enjoyed their sessions more than the control subjects. The researchers concluded that the use of acupuncture in patients undergoing IVF was not associated with an increase in pregnancy rates but did help women feel more relaxed and more optimistic. Domar, et al. (2009) The impact of acupuncture on in vitro fertilization outcome. Fertil Steril; 91: 723-6.
  • Acupuncture improves IVF success rates: A randomised controlled trial of 228 women receiving 3 sessions (one either side of embryo transfer and one earlier in the process) of acupuncture or non-invasive sham needling. The clinical pregnancy rates were 31% for acupuncture, 23% control. Pregnancy rates at 18 weeks were 28% and 18% respectively. The differences were not statistically significant but would be clinically significant. Smith, et al. (2006) Influence of acupuncture stimulation on pregnancy rates for women undergoing embryo transfer. Fertil Steril; 85 (5): 1352-8.
  • Acupuncture improves the success of IVF and ICSI: A randomised controlled trial that evaluated the effect of acupuncture on reproductive outcome in 273 women undergoing IVF/intracytoplasmic sperm injection (ICSI). One group of patients received acupuncture on the day of embryo transfer, another group on embryo transfer day and again 2 days later (i.e. closer to implantation day), and both groups were compared with a control group that did not receive acupuncture. Clinical and ongoing pregnancy rates were significantly higher in the first acupuncture group compared with controls (39% vs. 26% and 36% vs. 22%, respectively). The clinical and ongoing pregnancy rates in the second acupuncture group (36% and 26%, respectively) were higher than in controls, but the difference did not reach statistical difference. The researchers concluded that acupuncture on the day of embryo transfer significantly improves the reproductive outcome of IVF/ICSI, compared with no acupuncture. Westergaard, et al. (2006) Acupuncture on the day of embryo transfer significantly improves the reproductive outcome in infertile women: a prospective, randomized trial. Fertil Steril; 85: 1341-6.
  • Acupuncture regulates cortisol and prolactin during IVF: A study that looked at whether changes in serum cortisol and prolactin are affected by acupuncture in IVF patients. In all, 67 infertile women undergoing IVF were grouped as controls (IVF with no acupuncture) and treated (IVF with acupuncture) according to acupuncture protocols derived from randomized controlled trials. Cortisol levels in the acupuncture group were significantly higher on IVF medication days 7, 8, 9, 11, 12, and 13 compared with controls. Prolactin levels in the acupuncture group were significantly higher on IVF medication days 5, 6, 7, and 8 compared with controls. The researchers concluded that there appears to be a beneficial regulation of cortisol and prolactin with acupuncture during the medication phase of the IVF treatment. Magarelli, et al. (2008) Changes in serum cortisol and prolactin associated with acupuncture during controlled ovarian hyperstimulation in women undergoing in vitro fertilization-embryo transfer treatment. Fertil Steril; 92(6): 1870-9.
  • Acupuncture given during IVF halves miscarriage rate: Women who receive acupuncture during the stimulation phase of an in vitro fertilization cycle and again immediately after embryo transfer have a higher live-birth rate than do controls, according to the first acupuncture study with this end point. The miscarriage rate was almost halved in the acupuncture group (8% vs. 14%). Magarelli, et al. (2005) 12th World Congress on Human Reproduction, Venice Italy. OB/Gyn News.
  • Acupuncture reduces pain during egg retrival: Ninety patients undergoing IVF-EF oocyte retrieval were randomly divided into three groups: an acupuncture group with needles inserted into bilateral Hegu (LI 4) points, a placebo group given placebo needles, and a control group with routine oocyte retrieval. Each group had an indometacin enema 30 min before the operation. We compared the pain-rated index (PRI), visual analogy scale (VAS), and present pain intensity (PPI) immediately after operation and 1 h after operation. We also determined the neuropeptide Y (NPY) level of the follicular fluid. PRI, VAS, and PPI after operation and 1 h after operation in the acupuncture group were significantly lower than those in the control group (P 0.01). No obvious difference (P0.05) was observed in PRI, VAS, and PPI after operation and 1 h after operation between the placebo group and the control group. The NPY level of the follicular fluid in the acupuncture group was significantly higher than that in the control group (P0.01). No obvious difference (P0.05) was observed in the NPY level of the follicular fluid between the placebo group and the control group. The analgesic effect of acupuncture at Hegu in transvaginal oocyte retrieval using ultrasonography may be related to the increase in the NPY level of the follicular fluid. Zhang et al. (2013) Analgesic effect of acupuncture at Hegu (LI 4) on transvaginal oocyte retrieval with ultrasonography. J Tradit Chin Med; 33(3): 294-297.
  • Acupuncture improves the pregnancy and live birth rates of IVF: Women undergoing IVF in randomized controlled trials (RCTs) who were evaluated for the effects of acupuncture on IVF outcomes. The intervention groups used manual, electrical, and laser acupuncture techniques. The control groups consisted of no, sham, and placebo acupuncture. The major outcomes were clinical pregnancy rate (CPR) and live birth rate (LBR). Heterogeneity of the therapeutic effect was evaluated with a forest plot analysis. Publication bias was assessed by a funnel plot analysis. Twenty-four trials (a total of 5,807 participants) were included in this review. There were no significant publication biases for most of the comparisons among these studies. The pooled CPR (23 studies) from all of the acupuncture groups was significantly greater than that from all of the control groups, whereas the LBR (6 studies) was not significantly different between the two groups. The results were different when the type of control was examined in a sensitivity analysis. The CPR and LBR differences between the acupuncture and control groups were more obvious when the studies using the Streitberger control were ignored. Similarly, if the underlying effects of the Streitberger control were excluded, the LBR results tended to be significant when the acupuncture was performed around the time of oocyte aspiration or controlled ovarian hyperstimulation. Acupuncture improves CPR and LBR among women undergoing IVF based on the results of studies that do not include the Streitberger control. Zheng et al. (2012) Effects of acupuncture on pregnancy rates in women undergoing in vitro fertilization: a systematic review and meta-analysisFertility and Sterility; Vol. 97, No. 3.

Chinese herbs enhance the success of IVF

  • Chinese herbs improve the effects of fertility drugs during IVF: Four hundred and thirty-three subjects aged less than 42 years with infertility due to fallopian tube or male-related factors who were willing to undertake in vitro fertilization and embryo transplantation were randomly allocated to a Chinese herb intervention group (n=216) or a conventional treatment control group (n=217). The subjects in the intervention group received various Chinese herbs depending on their conventional treatment. Endometrial thickness, number of acquired eggs, and rates of normal fertility, high-quality embryos, biochemical and clinical pregnancy of subjects were assessed in both groups. The high-quality embryo rate of 51.9% , biochemical pregnancy rate of 51.0%, clinical pregnancy rate of 44.2% and endometrial thickness of (10.84±1.75) mm in the intervention group were all significantly higher than those in the control group [48.7%, 38.9%, 34.8%, and (10.52±1.50) mm, respectively; P0.05]. The normal fertility rate of 58.5% in the Chinese herb group was also significantly superior to the 54.7% achieved in the control group (P 0.01). There were no statistically significant differences (P0.05) in the average number of acquired eggs within a single cycle, incidence of excessive stimulation of ovary, rates of embryo transplantation or early abortion and birth of living babies between the two groups. Our findings indicate that Chinese herbs increase endometrial thickness, improve the quality of fertility and embryo, and promote embryonic nidation, thus enhancing the success rate of in vitro fertilization/intracytoplasmic sperm injection-embryo transplantation cycle. Using Chinese herbs improves the outcomes and safety of assisted reproductive technologies. Guo et al. (2014) Effects of Chinese herbs combined with in vitro fertilization and embryo transplantation on infertility: a clinical randomized controlled trial. J Tradit Chin Med; 34(3): 267-273.
  • Xiao Yao Wan improves the effects of FSH fertility drugs: Fifty-eight women with tubal infertility were randomized into two groups: 30 in an experimental group treated with Xiaoyao powder (Shugan) plus gonadotropin-releasing hormone analog (GnRHa)/follicle-stimulating hormone (FSH)/ human chorionic gonadotropin (hCG) and 28 in the control group who were treated with GnRHa/FSH/ hCG only. The total gonadotropin (Gn) doses required, endometrial thickness, oocyte numbers, high quality embryo production rate and pregnancy rate of the two groups were compared. The concentration of growth differentiation factor-9 (GDF-9) in follicular fluid was detected by western blotting and the expression of GDF-9 mRNA in granulosa cells was measured using reverse transcription-polymerase chain reaction amplification. In the experimental group, the Gn dose was significantly lower than that in the control group; the endometrial thickness, high quality embryo production and pregnancy rates were significantly higher and the expression of GDF-9 mRNA was also significantly higher than in the control group (all P0.05). Xiao Yao Wan can improve the pregnancy rate of women with tubal infertility; its mechanism is possibly related to the increased expression of GDF-9 in granulosa cells. Gao, et al. (2013) Effect of soothing liver therapy on oocyte quality and growth differentiation factor-9 in patients undergoing in vitro fertilization and embryo transfer. J Tradit Chin Med; 33(5): 597-602.

Acupuncture treats problems during pregnancy

  • Acupuncture treats pre-elampsia: Pregnant women with a diagnosis of preeclampsia were offered acupuncture and allocated into groups based on their choice: the acupuncture group (n=11) comprised women electing to receive treatment (up to 10 sessions over 2 weeks). The control group (n=11) was made up of women who declined and was matched for age, gestation at diagnosis, and parity. All women received usual care and underwent measurement of blood pressure (BP) at four time points: at baseline, at the end of the intervention, immediately before delivery, and postpartum (within 24 h). Patients in the acupuncture group had significantly lower BP at time of delivery, and postpartum, than patients in the control group (p0.05). The individual change in BP between baseline and the end of treatment was significantly greater in the acupuncture group versus the control group for both systolic BP (median (IQR) -8 (-3 to -14) vs +1 (-7 to +9) mm Hg, p=0.007) and diastolic BP (-3 (-1 to -3) vs +2 (-2 to +7) mm Hg. Acupuncture plus usual care was associated with a greater reduction in BP than usual care alone. Acupunct Med. 2015 Oct 29. pii: acupmed-2015-010893. Zeng, et al. (2015) Effects of acupuncture on preeclampsia in Chinese women: a pilot prospective cohort study. Acupunct Med. doi: 10.1136/acupmed-2015-010893.
  • Acupuncture very safe in pregnancy: Although the safety of acupuncture per se in pregnancy is reasonably well accepted, there remains debate regarding needling at points historically considered to be 'forbidden' during pregnancy. This article reviews the scientific literature on this topic. These findings are reassuring and will help individualised risk benefit assessment before treating pregnant women. Given the numerous evidence-based indications for obstetric acupuncture and lack of evidence of harm, risk:benefit assessments will often fall in favour of treatment. Carr. (2015) The safety of obstetric acupuncture: forbidden points revisited. Acupunct Med; 33(5):413-9. doi: 10.1136/acupmed-2015-010936.
  • Acupuncture treats nausea and vomitting during pregnancy: Reviews were found on postoperative sickness, chemotherapy-induced nausea and vomiting, and pregnancy-related nausea and vomiting. Results for postoperative nausea and vomiting show the most consistent results with 26 trials and more than 3000 patients showing the superiority of real P6 stimulation over sham for both adults and children and for both nausea and vomiting. Pooled data of trials including different antiemetics showed that P6 stimulation seems to be superior to antiemetic medication for nausea and equivalent for vomiting. P6 stimulation was similarly effective across the different methods of stimulation, both invasive or noninvasive. Results for chemotherapy-induced nausea and vomiting showed 11 trials and over 1200 patients. Electroacupuncture, but not manual acupuncture, was beneficial for first-day vomiting. Acupressure was effective for first-day nausea but not vomiting. Wristwatch-like electrical devices were not effective for any outcome. Results for pregnancy-related nausea and vomiting comprised six trials and approximately 1150 patients. Results were mixed with some trials showing positive and other trials equivocal results with no favor to a certain kind of method. Neiguan P6 stimulation may be beneficial for various conditions involving nausea and vomiting. Ezzo, et al. (2006) The Journal of Alternative and Complementary Medicine, 12(5): 489-495. doi:10.1089/acm.2006.12.489.
  • Acupuncture reduces miscarriage in pregnancy: A randomised controlled trial comparing acupuncture (plus moxibustion) to medication (oral clomiphene) in 120 women with infertility due to ovulatory disturbance. After treatment for 3 menstrual cycles women in both groups showed similar increases in ovulation rates. However, the pregnancy rate in the acupuncture group was significantly higher than that in the medication group (p0.05), due to lower levels of miscarriage. Song et al. (2008) [Clinical observation on acupuncture for treatment of infertility of ovulatory disturbance]. [Chinese] Zhongguo Zhenjiu. 28(1): 21-3
  • Acupressure reduces morning sickness: Double-blind, placebo-controlled study. 97 women with mean gestational length completed 8–12 weeks. Symptoms were recorded according to intensity, duration and nature of complaints. 71% of women in the intervention group reported both less intensive morning sickness and reduced duration of symptoms. Acupressure wristband might be an alternative therapy for morning sickness in early pregnancy, especially before pharmaceutical treatment is considered. Norheim, et al (2001) Acupressure treatment of morning sickness in pregnancy. A randomised, doubleblind, placebo-controlled study, Scandinavian Journal of Primary Health Care, 19:1, 43-47, DOI: 10.1080/02813430120819.
  • Moxibustion treats breech babies: A systematic review including 6 randomised controlled trials and a total of 1,087 pregnant women that assessed moxibustion for breech presentation. The rate of cephalic version among the moxibustion group was 72.5% versus 53.2% in the control group (relative risk, 1.36; 95% CI 1.17-1.58). In terms of safety, no significant differences were found in the comparison of moxibustion with other techniques. The reviewers concluded that moxibustion at acupuncture point BL67 has been shown to produce a positive effect, whether used alone or in combination with acupuncture or postural measures, in comparison with observation or postural methods alone, for the correction of breech presentation. Vas, et al. (2009) Correction of nonvertex presentation with moxibustion: a systematic review and metaanalysis. Am J Obstet Gynecol; 201: 241-59.
  • Moxibustion corrects breech presentation: A systematic review that evaluated the efficacy and safety of moxibustion to treat breech presentation. Ten randomised controlled trials involving 2,090 women and 7 controlled clinical trials involving 1,409 women were included. Meta-analysis of randomised controlled trials showed significant differences between moxibustion and no treatment (RR 1.35, 95% CI 1.20 to 1.51; 3 RCTs), but not between moxibustion and knee-chest position. Moxibustion plus other therapeutic methods showed significant beneficial effects (RR 1.36, 95% CI 1.21 to 1.54; 2 RCTs). For nonrandomised controlled trials, moxibustion was more effective than no treatment (RR 1.29, 95% CI 1.17 to 1.42; 2 CCTs) but not more effective than the knee-chest position treatment. The reviewers concluded that moxibustion, acupuncture and laser acupoint stimulation tend to be effective in the correction of breech presentation. Li et al. (2009) Moxibustion and other acupuncture point stimulation methods to treat breech presentation: a systematic review of clinical trials. Chin Med; 4:4.
  • Acupuncture treats breech presetation: A systematic review of studies that assessed the effectiveness of acupuncture-type interventions (moxibustion, acupuncture, or electro-acupuncture) on acupuncture point BL 67 to correct breech presentation compared to expectant management. Six randomised controlled trials and three cohort studies fulfilled the inclusion criteria. In the former, the pooled proportion of breech presentations was 34% following treatment versus 66% in the control group (OR 0.25, 95% CI 0.11-0.58). The pooled proportion in the cohort studies was 15% versus 36% (OR 0.29, 95% CI 0.19-0.43). The reviewers concluded that their results suggest that acupuncture-type interventions on BL 67 are effective in correcting breech presentation compared to expectant management. van den Berg I et al. (2008) Effectiveness of acupuncture-type interventions versus expectant management to correct breech presentation: a systematic review. Complement Ther Med; 16:92-100.
  • Moxibustion treats breech presentation: A modelling study to estimate the effectiveness and costs of breech version with acupuncture-type interventions, including moxibustion, on BL 67 compared to expectant management for women with a foetal breech presentation at 33 weeks gestation. The results suggested that such an intervention would reduce the number of breech presentations at term, thus reducing the number of caesarean sections, and so would be cost-effective compared to expectant management, including external cephalic version. van den Berg I e tal. (2010) Cost-effectiveness of breech version by acupuncture-type interventions on BL 67, including moxibustion, for women with a breech foetus at 33 weeks gestation: a modelling approach. Complement Ther Med; 18: 67-77.
  • Acupuncture reduces depression during pregnancy: A randomised controlled trial that assessed the efficacy of acupuncture for depression during pregnancy in 150 pregnant women given acupuncture specific for depression or one of two active controls: control acupuncture or massage. Treatments lasted 8 weeks (12 sessions). The primary outcome was the Hamilton Rating Scale for Depression, at baseline and after 4 and 8 weeks of treatment. Women who received acupuncture specific for depression experienced a greater rate of decrease in symptom severity (p0.05) compared with the combined controls (Cohen's d=0.39, 95% CI 0.01-0.77) or control acupuncture alone (p0.05; Cohen's d=0.46, 95% CI 0.01-0.92). They also had significantly greater response rate (63.0%) than the combined controls (44.3%; and control acupuncture alone (37.5%; p0.05). Symptom reduction and response rates did not differ significantly between controls. The researchers concluded that acupuncture specific for depression reduces symptoms and increases response rate in similar amounts to those observed with standard depression treatments and could be a viable treatment option for depression during pregnancy. Manber, et al. (2010) Acupuncture for depression during pregnancy: a randomized controlled trial. Obstet Gynecol; 115: 511-20.
  • Acupuncture reduces dyspepsia in pregnancy: A randomised controlled trial under real-life conditions that assessed the effects of acupuncture on symptomatic dyspepsia during pregnancy and compared this with a group of patients undergoing conventional treatment alone. A total of 42 conventionally-treated pregnant women were treated, or not, by acupuncture. They reported the severity of symptoms and the disability these were causing in daily aspects of life such as sleeping and eating, using a numerical rating scale. The study also observed the use of medications. Significant improvements in symptoms were found in the acupuncture group. This group also used less medication and had a greater improvement in their disabilities when compared with the control group. The researchers concluded that acupuncture may alleviate dyspepsia during pregnancy. da Silva JB et al. (2009) Acupuncture for dyspepsia in pregnancy: a prospective, randomised, controlled study. Acupunct Med; 27: 50-3.
  • Acupuncture can prevent preterm labour: Preterm labor (PTL) is one of the main causes of fetal mortality and morbidity in obstetrical medicine. Current methods of treatment are not very effective and often have significant side effects. For this reason new methods of preventing PTL are currently being sought. In Western medicine the newest development is oxytocin antagonists. In Oriental medicine acupuncture and moxibustion are being utilized for the purpose of stopping PTL. The goals of this study were to determine if acupuncture in pregnant rats can suppress oxytocin induced uterine contractions and to compare these results with those inhibited by an oxytocin antagonist. Uterine contractions were induced by continuous infusion of exogenous oxytocin. The first fetus in one uterine horn near the ovarian end was removed and distilled water-filled catheter was inserted into that vacated amniotic sac to measure uterine contractions as intrauterine pressure changes. Two acupoints of Ho-Ku (LI-4) and San-Yin-Chiao (Sp-6) were selected for acupuncture and Kuan-Yiian (Co-4) was used for moxibustion. The oxytocin-induced uterine contractions were significantly suppressed by acupuncture on the LI-4 (p 0.05), but not by Sp-6. Stimulation of Co-4 by moxibustion had no significant (p 0.05) tocolytic effect. The administration of oxytocin antagonist eliminated all the uterine contractions induced by oxytocin. The application of acupuncture to re-stimulate the activity that was suppressed by the oxytocin antagonist did not produce any positive results. However, prostaglandins did cause the uterus to contract. In conclusion, acupuncture on LI-4 was found to suppress uterine contractions induced by oxytocin in the pregnant rat. If acupuncture is similarly effective in counteracting the effects of oxytocin in women, then this may an alternative medical treatment for women in preterm labor. Sok, et al. (2000) The Effect of Acupuncture on Uterine Contraction Induced by Oxytocin. American Journal of Chinese Medicine, Vol. 28, No. 1, 35-40.

Acupuncture and moxibustion improve labour

  • Acupuncture reduces length of labour and need of oxytocin: In a randomized controlled trial 100 healthy parturients, with spontaneous rupture of membranes at term, were assigned to receive either acupuncture or no acupuncture. The main response variables were the duration of active labor, the amount of oxytocin given, and number of inductions. Duration of labor was significantly reduced (mean difference 1.7 h, p/0.03) and there was significant reduction in the need for oxytocin infusion to augment labor in the study group compared to the control group (odds ratio 2.0, p/0.018). We also discovered that the participants in the acupuncture group who needed labor induction had a significantly shorter duration of active phase than the ones induced in the control group (mean difference 3.6 h, p/0.002). These findings remained significant also when multiple regression was performed, controlling for potentially confounding factors like parity, epidural analgesia, and birth weight. Acupuncture may be a good alternative or complement to pharmacological methods in the effort to facilitate birth and provide normal delivery for women with prelabor rupture of membranes. Gaudernack (2006) Acupuncture administered after spontaneous rupture of membranes at term significantly reduces the length of birth and use of oxytocin. A randomized controlled trial. Acta Obstetricia et Gynecologica; 85: 1348,1353. DOI: 10.1080/00016340600935839.
  • Acupuncture significantly reduces the need for epidurals in labour: Ninety parturients who delivered during the period April 12, 1999 and June 4, 2000. Forty-six parturients were randomised to receive acupuncture treatment during labour as a compliment, or an alternative, to conventional analgesia. Assessments of pain intensity and degree of relaxation during labour, together with evaluation of delivery outcome. Acupuncture treatment during labour significantly reduced the need of epidural analgesia (12% vs 22%, relative risk [RR] 0.52, 95% confidence interval [CI] 0.30 to 0.92). Parturients who received acupuncture assessed a significantly better degree of relaxation compared with the control group (mean difference 0.93, 95% CI 1.66 to 0.20). No negative effects of acupuncture given during labour were found in relation to delivery outcome. The results suggest that acupuncture could be a good alternative or complement to those parturients who seek an alternative to pharmacological analgesia in childbirth. Further trials with a larger number of patients. Ramnerö et al. (2002) Acupuncture treatment during labour—a randomised controlled trial. BJOG: an International Journal of Obstetrics and Gynaecology, Vol. 109, 637–644. DOI: 10.1111/j.1471-0528.2002.01212.x
  • Acupressure reduces labour pain: This study examines and compares the effect of LI4 and BL32 acupressure with each other and control group on labor pain and delivery outcomes. In this randomized controlled trial, 105 primiparous women in active phase of first-stage of labor were equally assigned to two experimental groups [acupressure on LI4 (n=35) or BL32 (n=35)] and a control group (n=35). The experimental groups received routine labor care and acupressure in LI4 or BL32 points in three cervical dilatations (4-5, 6-7, and 8-10cm). The control group only received routine labor care. Pain reduction was significantly greater in LI4 and BL32 groups compared with control in all periods of study. Also, acupressure on BL32 point was superior to LI4 point in pain relief in the first and second but not third intervention. No statistically significant difference was observed in terms of delivery outcomes. Acupressure on BL32 and LI4 points are effective in reducing labor pain compared to control group with a slight superiority for BL32 points. Acupressure on these points could apply for relief pain in labor as an inexpensive and easy to administered method. Ozgoli et al. (2016) Effect of LI4 and BL32 acupressure on labor pain and delivery outcome in the first stage of labor in primiparous women: A randomized controlled trial. Complement Ther Med; 29:175-180. doi: 10.1016/j.ctim.2016.10.009.
  • Acupuncture or acupressure reduces labour pain: Many women would like to avoid pharmacological or invasive methods of pain management in labour and this may contribute towards the popularity of complementary methods of pain management. This review examined evidence supporting the use of acupuncture and acupressure for pain management in labour We included 13 trials with data reporting on 1986 women. Nine trials reported on acupuncture and four trials reported on acupressure. Acupuncture and acupressure may have a role with reducing pain, increasing satisfaction with pain management and reduced use of pharmacological management. Smith, et al. (2011). Acupuncture or acupressure for pain management in labour. Cochrane Database of Systematic Reviews, Issue 7.
  • Acupuncture and acupressure reduce labour pain and duration: The purpose of this study was to evaluate the effects of SP6 acupressure on labor pain and delivery time in women in labor. Seventy-five (75) women in labor were randomly assigned to either the SP6 acupressure (n = 36) or SP6 touch control (n = 39) group. The 30-minute acupressure or touch on SP6 acupoint was performed. There were significant differences between the groups in subjective labor pain scores at all time points following the intervention: immediately after the intervention (p = 0.012); 30 minutes after the intervention (p = 0.021); and 60 minutes after the intervention (p = 0.012). The total labor time (3 cm dilatation to delivery) was significantly shorter in the SP6 acupressure intervention group than in the control group (p = 0.006). These findings showed that SP6 acupressure was effective for decreasing labor pain and shortening the length of delivery time. SP6 acupressure can be an effective nursing management for women in labor. Mi et al. (2004). Effects of SP6 Acupressure on Labor Pain and Length of Delivery Time in Women During Labor. The Journal of Alternative and Complementary Medicine, 10(6): 959-965.
  • Acupressure ripens the cervix: Cervical ripening is one of the main stages of initiation labor. Acupressure in Chinese medicine is considered as an invasive technique, which through reliving oxytocin ripens the cervix. Acupoint Sanyinjiao (SP6) was selected in this study because it is the acupoint selected in gynecology and it is easy for women to locate and apply pressure without medical assistance. There was a significant difference between mothers' educations in the three groups. Most of the mothers (59.5%) in the researcher-performed acupressure group had secondary education. Cervical ripening was significantly different between the three groups after 48 hours (P = 0.05), yet there was no significant difference after 96 hours and at the time of admission. Mean Bishop score was enhanced after 48 hours in the researcher-performed acupressure group (P = 0.021) and the self-performed acupressure group (P = 0.007) in comparison to the control group. The results showed that acupressure is a safe technique and leads to cervical ripening. Thus, regarding the desired results that were achieved when mothers applied acupressure themselves, it could be suggested that it is beneficial for mothers to be trained to apply this method at home. Torkzahrani, et al. (2015) Effect of Acupressure on Cervical Ripening. Iran Red Crescent Med J. 24;17(8):e28691. doi: 10.5812/ircmj.28691.
  • Acupuncture reduces labour duration: Nowadays, acupuncture is widely used to manage pain, and childbirth is a condition requiring appropriate pain management interventions. In this study, we investigated the effects of acupuncture on labor pain, serum cortisol level, and duration of labor. We conducted a randomized, single-blind, controlled trial that included 63 nulliparous women: 32 in the study group and 31 in the control group. Acupuncture was performed at the SP-6 and the LI-4 points in the study group, and sham acupuncture was performed at the same points in the control group. Our results show that acupuncture is significantly associated with a decreased duration of labour. Asadi, et al. (2015) Effects of LI-4 and SP-6 Acupuncture on Labor Pain, Cortisol Level and Duration of Labor. J Acupunct Meridian Stud; 8(5):249-54. doi: 10.1016/j.jams.2015.08.003.
  • Moxibustion reduces labour pain: A randomised controlled trial to investigate the effect of moxibustion at Spleen 6 (SP 6) for uterine contraction pain in labour, and evaluate its safety. In all, 174 women with singleton pregnancies and cephalic presentation were allocated to a moxibustion group, a placebo-treated group and ‘blank’ group. Moxibustion was applied for 30 minutes when the cervix was 3cm dilated. The uterine contraction pain was assessed using a Visual Analogue Scale (VAS). The VAS scores in the treatment group were obviously decreased after 15 and 30 minutes of moxibustion (both p0.05), but there were no obvious changes in VAS scores in placebo treated group and the blank group. VAS scores decreased more with moxibustion than the other two groups (all p0.05). After 30 minutes of moxibustion, the effective rate of labour analgesia was 69.5% in the moxibustion group (vs. 45.6% in the placebo and 43.1% in the blank group, p0.05). Postpartum haemorrhage was less, and the Apgar score of newborn was higher, in the moxibustion group than in the placebo group and blank group (all p0.05). The researchers concluded that moxibustion at Spleen 6 can relieve uterine contraction pain, and is not associated with side effects in either the mother or infant. Ma et al. (2010) Effect of moxibustion at Sanyinjiao (SP 6) for uterine contraction pain in labor: a randomized controlled trial [Article in Chinese] Zhongguo Zhen Jiu; 30: 623-6.
  • Acupuncture reduces pain in labour: A systematic review that examined currently available evidence supporting the use of alternative and complementary therapies for pain management in labour. It included three trials of acupuncture involving 496 women. These showed a decreased need for pain relief. The reviewers concluded that acupuncture may be beneficial for the management of pain during labour, but the small number of women studied was a limitation. Smith et al. (2006) Complementary and alternative therapies for pain management in labour. Cochrane Database Syst Rev 18;(4): CD003521
  • Acupuncture reduces labour pain: A systematic review that critically evaluated the evidence on acupuncture for labour pain management. Ten randomised controlled trials involving 2,038 women receiving acupuncture alone, or as an adjunct to conventional analgesia, for pain relief in labour were included. Pain intensity on a 100-mm visual analogue scale and uptake of other analgesic methods were used as primary outcomes. VAS for pain intensity data were available in seven studies, and pooling of this data showed that acupuncture was not superior to minimal acupuncture at 1 hour and at 2 hours. Patients reported significantly reduced pain by 4% and 6% during electroacupuncture (EA) treatment at 15 and 30 minutes compared with placebo EA. Compared with no intervention, acupuncture reduced pain by 11% for the first 30 minutes. In trials where acupuncture was compared with conventional analgesia, women receiving acupuncture required less meperidine and other analgesic methods. No acupuncture-related adverse events were reported. Cho et al. (2010) Acupuncture for pain relief in labour: a systematic review and meta-analysis. BJOG; 117(8): 907-20.
  • Acupuncture can induce labour: A systematic review of the existing scientific evidence on the potential role of acupuncture for induction of labour during pregnancy. Ten studies were identified. The duration of labour as a result of acupuncture treatment ranged from 10 hours 20 minutes to 29.1 hours. All of the studies demonstrated labour induction by acupuncture treatment. However, because two (of the five) randomised controlled trials reported that there was no statistically significant effect of acupuncture, these results are more suggestive than definitive. The reviewers concluded that, although the definitive role of acupuncture in inducing labour is still yet to be established, the existing studies suggest that acupuncture may be beneficial in labour induction. Lim et al. (2009) Effect of acupuncture on induction of labor. J Altern Complement Med; 15: 1209-14.
  • Acupuncture reduces pain in labour and need for pain relief medication: Many women need some kind of analgesic treatment to relieve pain during childbirth. The objective of our study was to compare the effect of acupuncture with transcutaneous electric nerve stimulation (TENS) and traditional analgesics for pain relief and relaxation during delivery with respect to pain intensity, birth experience, and obstetric outcome. A randomized controlled trial was conducted with 607 healthy women in labor at term who received acupuncture, TENS, or traditional analgesics. Primary outcomes were the need for pharmacological and invasive methods, level of pain assessed by a visual analogue scale, birth experience and satisfaction with delivery, and pain relief evaluated at 2 months postpartum. Secondary obstetric outcomes were duration of labor, use of oxytocin, mode of delivery, postpartum hemorrhage, Apgar score, and umbilical cord pH value. Analysis complied with the intention-to-treat principle. Use of pharmacological and invasive methods was significantly lower in the acupuncture group (acupuncture vs traditional, p 0.001; acupuncture vs TENS, p= 0.031). Pain scores were comparable. Mean Apgar score at 5 minutes and umbilical cord pH value were significantly higher among infants in the acupuncture group compared with infants in the other groups. Acupuncture reduced the need for pharmacological and invasive methods during delivery. Acupuncture is a good supplement to existing pain relief methods. Borup, et al. (2009) Acupuncture as Pain Relief During Delivery: A Randomized Controlled Trial, BIRTH 36:1.
  • Acupuncture reduces labour pain, duration and the need for oxytocin supplementation without side effects: Acupuncture is as an ancient system of diagnosis and treatment. It is regarded as a complementary tool for pain management. To assess the effects of acupuncture on nulliparous women during labour with respect to pain, labour duration and maternal acceptability. One hundred and forty-four healthy nulliparous women in active phase were randomised into the study and control group, receiving real and minimal acupuncture, respectively. Visual analogue scale was used to assess pain. Objectives were to evaluate acupuncture effect on pain and labour duration and patients’ willingness to receive acupuncture for subsequent pregnancies. Visual analogue scale pain score in the study group was lower after two hours. Active phase duration and the oxytocin units administered were lower in the study group. Study group patients had greater willingness to receive acupuncture again. No adverse effects were detected. Acupuncture could reduce pain experience, active phase duration and oxytocin units. Patients were satisfied and no adverse effects were noted. Hantoushzadeh et al. (2007) The effects of acupuncture during labour on nulliparous women: A randomised controlled trial. Australian and New Zealand Journal of Obstetrics and Gynaecology; 47: 26–30.