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Chinese Medicine & Assisted Reproductive Technologies: Synergy by Diane K. Cridennda, L.Ac, D.O.M. and Paul C. Magarelli, M.D., Ph.D
Since 1985, the Society for Assisted Reproductive Technology and recently the Center for Disease Control (CDC) have reported Invitro Fertilization (IVF) outcomes for clinics in the United States. In 1985, the average pregnancy rates/cycle for all IVF cycles was 3 to 5 percent pregnant per cycle. In 1999, these numbers rose to 30 percent per cycle, an almost 10-fold increase! Although these numbers are impressive, most couples have only one chance to achieve a pregnancy from IVF. Most couples, in their hearts, believe their chance far exceeds the 30 percent for other couples. Unfortunately,
this is not the case.
Disappointment, frustration, and sorrow are all too frequent emotions exhibited by patients. Western medicine continues to make advancements that slowly nudge pregnancy rates higher and higher. However, some health care systems have been dealing with the issue of infertility for over 5000 years. I am referring to TCM, traditional
Chinese medicine. Can a combination of West and East treatments enhance IVF outcomes further?
Two studies reporting on the use of acupuncture for the treatment of IVF couples have received the most attention in the U.S.:
1. Influence of acupuncture on the pregnancy rate in patients who undergo assisted reproduction therapy. Paulus et al. Fertility & Sterility Vol 77:No.4, April 2002
2. Reduction in blood flow impedance in the uterine arteries of infertile women with electro-acupuncture. Stener-Victorin et al. European Society for Human Reproduction and Embryology. June 1995. Each study demonstrated, in a limited number of patients, a 10 to over 15 percent improvement in pregnancy rates in those couples that augmented their traditional IVF treatments with acupuncture. It took over eight years for a 10 percent improvement in SART statistics and four more years to improve it by another 10 percent. These studies would suggest that providing patients with acupuncture treatments is a very positive practice.
At Reproductive Medicine & Fertility Center in Colorado Springs, Colorado, the authors conducted a three-year study examining the impact of each acupuncture protocol reported above and a combination of both protocols on reproductive outcomes in over 160 patients. The study, which has been submitted for presentation and publication, reported a 15 percent overall benefit to patients using acupuncture combined with traditional IVF or IVF & ICSI (50 percent pregnancy
rates per cycle in these acupuncture treated patients). It also reported that "poor prognosis" patients (those patients that have a very low chance of success) could be "cured" or made to have similar outcomes to "easy" fertility patients by the use of acupuncture. This remarkable finding needs further study; however, the implication is tremendous to those couples who have given up trying because they were told that they had little or no chance of getting pregnant by
traditional IVF treatments.
TCM is not only acupuncture. TCM also incorporates herbal therapy, Tui Na (a specialized form of massage), Gua Sha (a scraping of the skin that enhances healing), Moxa (the use of smoking herbs), and newer technologies such as Electro-stimulation Acupuncture as reported in Stener-Victorin's article. Few practitioners of acupuncture have worked directly with a reproductive endocrinologist. The chance for synergy between these two specialists is great. Studies that further define ways that TCM can improve IVF outcomes may well include these modalities.
The key to success for couples that want to embrace this East/West approach is to be treated at a medical practice that has embraced this type of synergistic relationship with a TCM specialist. Also, it is imperative that the certifications of both the reproductive endocrinologist and acupuncturist are intact. Only disposable, one-use needles should be used and, for now, strict adherence to the protocols outlined in the two articles be followed. Finally, development of an acupuncture consortium of certified acupuncturists that will provide these IVF treatments on a seven-day-per-week schedule is imperative. The pre/post embryo transfer protocol describe by Paulus et al may well involve weekends and holidays. This is usually not the standard of practice for most TCM practitioners, so the consortium should be intact before these services are offered.
There are other secondary benefits from acupuncture that our patients report:
* Reduction in stress is a very frequent comment
* Greater attunement to their own bodies and the changes they experience
* First fear of acupuncture needles, then the treatment is kindly referred to as "needle naps", i.e., the needles go in and the patient immediately falls into a very restful sleep
* Overall sense of improved well being
* The patients feel they now have some control and can contribute to the IVF process
We currently are continuing our research into this exciting area and have expanded our investigation into the role of specific micronutrients in male-factor infertility and the use of TCM for recurrent miscarriages.
Diane K. Cridennda, L.Ac, D.O.M.
Doctor of Oriental Medicine
East Winds Acupuncture
Colorado Springs, CO
719-520-5056
Paul C. Magarelli, M.D., Ph.D.
Reproductive Endocrinologist &Infertility Specialist
Reproductive Medicine & Fertility Center
Colorado Springs, CO 80910-3161
719-475-BABY, 877-475-BABY
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