Acupuncture improves fertility for infertile women without undergoing assisted reproductive techniques (ART)

Acupuncture has been popular for decades to help women’s fertility, but the effectiveness is still in debate. What is the latest development of research on this aspect? A paper analysed data up to June 2018 to study the effectiveness of acupuncture for infertile women with natural conception.

22 trials with a total of 2591 participants were included. The participants included were women aged 20–40 years, a husband with semen of normal quality and shape, women who failed to conceive with unprotected sexual life for 1 year, women with a gynecological diagnosis of infertility, women not receiving treatment by assisted reproductive technology. The experimental group received acupuncture or its combined therapy, and the control group received other standard therapies, such as injected Western drugs and oral Western medication. They measured pregnancy rate, which was confirmed with a pregnancy test and ultrasound,  ovulation rate, endometrial thickness, endocrine indexes, such as luteinizing hormone (LH) and follicle stimulating hormone (FSH), and adverse events.

The results show that

1, the pregnancy rate is significantly increased with acupuncture treatment with or without other intervention such as Chinese medicine or Western medicine; pregnancy rate is increased with all types of infertility such as ovulation disorders or other types of infertility.

2, ovulation rate is increased with acupuncture treatments.

3, the level of LH is significantly improved with acupuncture treatments.

4, the level of endometrial thickness is significantly improved with acupuncture treatments.

5, fewer side effects occurs with acupuncture treatments.

References

Yun L et al Medicine (Baltimore). 2019 Jul;98(29):e16463. doi: 10.1097/MD.0000000000016463.

Acupuncture combined clomiphene citrate for anovulatory infertility

Acupuncture is a popular therapy for women fertility treatment which is supported by many researches. A recent review evaluated the comparative effectiveness of acupuncture or acupuncture combined with clomiphene citrate (CC) versus CC alone on the outcomes of anovulatory infertility. In this study 1441 women were included. They found that patients who received acupuncture as a separate treatment modality had higher pregnancy rate and larger the maximum follicular diameter when compared with CC alone. There was a reduction in the rate of pregnancy loss when acupuncture was used as a separate treatment compared with CC alone. They concluded that the use of acupuncture as a monotherapy significantly improved the rate of pregnancy among the study participants compared with the use of CC alone.

References

Gao et al Acupunct Med. 2020 Feb;38(1):25-36. doi: 10.1136/acupmed-2017-011629. Epub 2019 Oct 3.

Acupuncture improves blood circulation

Color Doppler imaging (CDI) can be used to noninvasively create images of human blood vessels and quantitatively evaluate blood flow in real-time. The purpose of this study was to assess the effects of acupuncture on the blood flow of the peripheral, mesenteric, and retrobulbar arteries by CDI. Statistical significance was defined as P values less than 0.05. Blood flow in the radial and brachial arteries was significantly lower during needle stimulation on LR3 than before in healthy volunteers, but was significantly higher after needle stimulation than before. LR3 stimulation also resulted in a significant decrease in the vascular resistance of the short posterior ciliary artery and no significant change of blood flow through the superior mesenteric artery (SMA) during acupuncture. In contrast, ST36 stimulation resulted in a significant increase in blood flow through the SMA and no significant change in the vascular resistance of the retrobulbar arteries. Additionally, acupuncture at previously determined acupoints in patients with open-angle glaucoma led to a significant reduction in the vascular resistance of the central retinal artery and short posterior ciliary artery. Our results suggest that acupuncture can affect blood flow of the peripheral, mesenteric, and retrobulbar arteries, and CDI can be useful to evaluate hemodynamic changes by acupuncture.

References

Shin Takayama, et al Evid Based Complement Alternat Med. 2012; 2012: 513638.

Study suggested that stress has negative impact on women’s fertility

In North America, 20%–25% of women and 18%–21% of men of reproductive age report daily psychological stress. A study has assessed the association of stress and fertility in couples from the general population.

The data used in this study was from Pregnancy Study Online, a web-based preconception cohort study of pregnancy planners from the United States and Canada (2013–2018), to examine the association between women’s and men’s perceived stress levels prior to conception and fertility. Women (aged 21–45 years) and their male partners (aged ≥21 years) who were attempting conception without fertility treatment were chosen.

Perceived stress was measured using the 10-item Perceived Stress Scale (PSS). Pregnancy information was checked using bimonthly follow-up questionnaires of female participants. 4,769 couples participated the study until self-reported pregnancy, initiation of fertility treatment, loss to follow-up, or 12 menstrual cycles of attempt time, whichever came first.

Higher PSS scores among the women, not men associated with slight reductions in fertility was found in this study.

References

Amelia K Wesselink American Journal of Epidemiology, Volume 187, Issue 12, December 2018, Pages 2662–2671

Pregnancy acupuncture in the UK.

Recently a survey in the UK was to explore how acupuncturists used acupuncture for maternity care within their women's health practices. 114 survey forms were sent and 99 replies were received, a response rate of 86.8%. The result has shown that in addition to fertility and menstrual conditions, the majority of the practitioners (87 [87.8%]) had treated at least 1 pregnant woman each. The most-common maternity situations encountered were: birth preparation (84 [96.5%]); nausea & vomiting (82 [94.2%]); and inducing labor (79 [90.8%]). More than 50% of the practitioners were also treating lower-back and pelvic pain (77 [88.5%]), breech presentations (74 [85.0%]), threatened miscarriages (55 [63.2%]), and headaches/migraines (46 [52.8%]). Greater number of referrals were received from medical health professionals for pregnancy (54 [65.8%]) than for fertility (16 [19.5%]) or menstrual conditions (8 [9.7%]). They concluded that The most frequently treated menstrual conditions were for irregular periods, menopause, and premenstrual syndrome, while women seeking treatment due to a medical diagnosis, general fertility health, and stress and relaxation were the most-frequent fertility issues. Although the most frequently treated pregnancy conditions concerned nausea, birth preparation, and labor induction, more than half of the practitioners were also treating pregnancy-related lower-back and pelvic pain, breech presentations, threatened miscarriages, and headaches and migraines. Referrals from Western medical practitioners were more common for maternity acupuncture than for fertility or menstrual health.

References

Betts D et al Med Acupunct. 2019 Oct 1;31(5):274-280. doi: 10.1089/acu.2019.1386. Epub 2019 Oct 17.

Acupuncture is effective for migraines.

A migraine is usually a moderate or severe headache felt as a throbbing pain on 1 side of the head. Propranolol is recommended for preventing migraine attacks and acupuncture can be used to treat migraines effectively. A new study compared acupuncture or propranolol with sham acupuncture, placebo, waiting-list control or usual care. The analysis showed that acupuncture had a significant advantage over propranolol in reducing migraine episodes over a 4-week period. Acupuncture also had a significant advantage over waiting-list control in decreasing migraine frequency. Acupuncture caused fewer adverse events than propranolol.

References
Chen et al J Neurol. 2020 Jan;267(1):14-25. doi: 10.1007/s00415-019-09510-x. Epub 2019 Aug 21.

Effect of acupuncture on nausea and vomiting in pregnancy

Up to 90% of pregnant women experience nausea and vomiting. Hyperemesis gravidarum is an extreme end of hyperemesis or morning sickness which is prolonged and severe nausea and vomiting in pregnancy. One of the main dangers of this condition is dehydration. Women with hyperemesis gradidarum could be constantly nausea and vomiting many times a day and it is difficult to keep fluids within the body. It could cause lot of weight loss, electrolyte imbalance and blood volume depletion. This condition is caused by hormone in pregnancy and is improved when the hormone levels go down as pregnancy turns to 13 weeks. Sometimes it could continue throughout of pregnancy. This condition is not likely to cause any harm to the baby. But there is a risk of the baby being born with a low birth weight if there is a significant weight loss during the pregnancy. Intravenous fluids and medication are used to control the vomiting and nausea.

Foods in rich carbohydrates and low fat and acid are recommended. Recommended foods include Light snacks, nuts, dairy products, beans and dry and salty biscuits. Electrolyte-replacement drinks and taking nutritional supplements are beneficial for maintenance of electrolyte balance and sufficient calories. Intake of food rich in protein is recommended. Use of ginger and vitamin B6 are effective though there is limited evidence.

Acupuncture was used in China to treat morning sickness. Carisson CP et al from University Hospital, Lund Sweden conducted a randomized placebo controlled trial to study the effect of acupuncture in treating morning sickness. Acupuncture treatments were given three times daily on treatment days. Each treatment lasted for 30 minutes. Acupuncture point PC6 was selected. Women in the acupuncture group had significantly quicker decrease in the amount of nausea they experienced compared with the placebo control group. There was also a significant difference in the amount of vomiting between the acupuncture and placebo groups. In acupuncture group there were fewer patients vomiting. There was no significant difference of food intake between the two groups. There were no side effects observed. The possible mechanisms for the acupuncture inhibiting nausea and vomiting include that acupuncture inhibits nociceptive transmission and autonomic reflexes; acupuncture decreases pain in the system; acupuncture has effect on gastric intestine tract; the effect of acupuncture is through somatovisceral reflexes.