Infertility may be due to factors in either the male or female partner. It has been estimated that 40% of infertility is due to male causes and another 40% is due to female causes. In the remaining 20%, the cause is not clear, although a significant proportion is thought to be due to immune-related problems and to undiagnosed endometriosis.
Acupuncture balances body function and promotes normal activity in the reproductive organs. It helps regulate the complex hormonal cycle involved in conception. While abnormal thyroid gland function may impair fertility, the pituitary gland is the main regulatory endocrine organ in the body and plays a critical role in conception. It is involved in regulating ovulation as well as in the preparation of the uterus for implantation. It is also involved in the ensuing hormonal changes following successful implantation of the fertilised egg. In men, the pituitary is also involved in regulating the production of sperm. Acupuncture helps with the overall regulation of hormones involved in conception in both men and women, and this role is important in people seeking treatment independent of assisted reproductive technology (ART). It also allays anxiety and indirectly helps pituitary function through its effect on the hypothalamus, a part of the brain which sits above the pituitary gland and modulates its function.
Acupuncture helps regulate the function of muscles in the reproductive organs. This is demonstrated in the treatment of period pain, when relief of pain can be felt while acupuncture treatment is in progress. Through regulation and coordination of muscle function in the uterus and fallopian tubes, it facilitates transport of the egg to the uterus and enhances implantation and retention of the fertilised egg. Acupuncture is also reported to improve circulation to the uterus and to thicken the endometrial lining, further improving the likelihood of implantation. It is also thought to alter the quality of cervical mucus thereby facilitating passage of sperms and enhancing the chances of fertilisation of the ovum.
Impaired sperm production may be due to the production of auto-antibodies to sperm in men. This may occur as a consequence of trauma, surgery or infection. Anti-sperm antibodies may also develop in the female partner, when a woman becomes sensitised to her partner’s sperm. Both factors may contribute to difficulty in conception. Immune antibodies may also develop against ovarian tissues, and while it is not known if this contributes significantly to infertility, it is thought that this will eventually lead to premature ovarian failure. Acupuncture modulates immune function. It enhances immunity during infection, but selectively dampens immune activity when there is immune dysfunction. It is likely that this immuno-suppressive effect is a significant factor in improving conception in people with infertility problems.
The role of acupuncture in assisting men with fertility problems has been reported in a number of studies. An increase in sperm numbers was noted following acupuncture in a small study of men with low sperm count. There have also been reports of increases in sperm motility following acupuncture. Acupuncture has been reported to be as effective as use of steroids in improving sperm quality in men who develop auto-antibodies to sperms.
The role of acupuncture in assisting conception was noted in a report comparing the effects of acupuncture with use of the fertility drug clomid. This report showed that acupuncture was as effective as the use of clomid in assisting conception, with 50% of subjects conceiving after 3 months. Compared to acupuncture, which produces a sense of well being and relaxation, Clomid is associated with side effects which include abdominal distension, flushes, visual disturbances, ovarian cysts and multiple pregnancies.
Acupuncture has also been reported to increase the rate of successful implantation when used in conjunction with ART. In a recent study comparing the effect of acupuncture in ART, the rate of implantation was increased from 26% in the group not having acupuncture to 42% in the group treated with acupuncture.
Acupuncture may be used on its own to facilitate conception. It can be used for the treatment of both male and female partners with infertility problems. Because it has minimal side effects and generally produces a feeling of relaxation and well being, it has a very useful role in the early treatment of infertility.
Before proceeding with acupuncture, proper assessment of the couple is important, to exclude people with anatomical, infective, genetic and other causes of infertility where acupuncture will not help.
Acupuncture can be used in conjunction with ART, where it not only improves the rate of implantation but will minimise the side effects of medications used with ART.
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