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Acupuncture

Many large clinics in major U.S. cities now integrate acupuncture into treatment. Patients often have difficulty interpreting how acupuncture works, and whether it’s effective. Here we take a closer look with help from experts, most of whom have a western-treatment background.

Acupuncture and Fertility Treatments

Acupuncture fits into a broader treatment approach known as traditional Chinese medicine, or TCM. Whereas 10 or 15 years ago, TCM approaches were considered fringe within the fertility field, today 24% of patients attend clinics that offer acupuncture services, according to our data.

Theoretically, there are multiple ways in which acupuncture helps fertility. The first is by increasing blood flow to the ovaries, which helps to stimulate as many follicles as possible. Post-retrieval, enhanced blood flow to the endometrium helps keep the uterine lining healthy. Additionally, acupuncture is believed to help keep inflammatory responses in check, especially critical for women with PCOS, while generally alleviating levels of stress in the body.

So does it all work? There have been more than 40 studies looking specifically at how the use of acupuncture impacts fertility treatment outcomes. Looking at the body of evidence, it can be hard to draw conclusions. Probably the most detailed rundown was done by Eric Manheimer in 2008, and the most readable by Belinda Anderson and Lara Rosenthal in 2013. Both studies found that in many cases, acupuncture has clearly improved success rates, but not necessarily when compared with "sham" treatments. However, the sham treatments themselves could be therapeutic, and often the acupuncture doses studied — only a few sessions — are too few to have a meaningful therapeutic benefit. Along those lines, there is evidence that the more acupuncture a patient receives, the more benefit it offers. Ultimately, we can probably classify this under the category of "way more research still to be done."

One question that arises is how much treatment patients should undergo to improve their likleihood of success. Most clinicians will tell you to plan for at least three months of treatment, as that is the period of time required for the egg and sperm cells to grow and participate in the process.

At the same time, acupuncture can cost upwards of $100 per session, and most patients will pay out of pocket. Take into account that the ideal amount of treatment is done weekly for months, and the costs can add up. For many patients, getting to acupuncture sessions creates duress and thus negates some of the therapeutic benefit. Whether it is worth the trade-off is very much a personal decision.

When is acupuncture less effective? Typically if there is a tubal blockage or an issue of fibroids, that's beyond the scope of acupuncture treatment. Similarly, if a woman is in her late 30s or early 40s and suffers from poor egg equality, acupuncture won't address that issue.

Meanwhile, many Western fertility doctors take a more cautious stance on the use of Chinese herbs during fertility treatment. Their fear is that taking herbs concurrently with follicle-stimulating hormones could cause a bleeding event during surgery.

Even most acupuncturists we interviewed, who are trained in Western medicine, think it's a mistake to try herbs during an IVF cycle. However, when a patient is not currently in a treatment cycle, many acupuncturists consider Chinese herbs to be their most effective form of therapy, specifically for women with a thin uterine linining, who have a high FSH, or who have early menopausal symptoms. Seeing as most herbs are imported from China, where regulation on safety is weak, acupuncturists recommend you carefully consider where you procure these herbs from.

As you'd expect, there are generalist acupuncturists and those who are trained to treat fertility patients. Most acupuncturists, even the specialists, will attest that generalists should still be of some use. Yet, specialists are far better trained in identifying the underlying fertility issues and constructing therapeutic approaches while taking into account the Western therapies being used. At a minimum, patients should look for a clinician who is licensed, and listed with the NCCAOM. Additionally, there is a society that accredits fertility acupunturists known as ABORM, but many skilled and well-regarded fertility acupuncturists have decided against getting the accredition.