Acupuncture: An Alternative Approach to Infertility


While the notion of “infertility treatment” typically conjures images of invasive insemination procedures, acupuncture has been used for thousands of years to increase the chances of natural pregnancy. Indeed, many contemporary acupuncturists are pairing their personalized practice of needles with herbal treatments to enhance the fertility of their patients … and finding high rates of success.

Acupuncture draws from traditional Chinese medicine, which views physical symptoms as caused by alterations in the flow of the body’s qi (pronounced “chee”), or energy, whether by illness, stress, or other factors. By placing very small, fine needles into particular points of the body called the energy meridians, acupuncture shifts the qi to restore balance. It is used to treat a host of health care needs, including chronic pain, insomnia, allergy symptoms, stress, and smoking cessation.

When it comes to infertility treatment, acupuncture stands apart from traditional Western practices in that it is not a medical intervention; rather, it is process-oriented. The personalized care consists of regular acupuncture sessions and a regiment of Chinese herbs, as well as coaching on diet. Patients typically visit their acupuncturists at least once a week. For most patients, pregnancy happens within six months after beginning treatment; some happen much more quickly, some take longer, and still others, of course, simply do not happen. Unlike Western treatment with assisted reproductive technology, which often requires patients to take strong fertility drugs, there are nearly no side effects to acupuncture.

At the Acupuncture Center for Reproductive Health in New Jersey, Candace Jania said that her practice is made up of about 90 percent people who are looking to enhance their fertility. Nearly all of her patients come by her practice through personal referral. Many of her patients have already been through Western procedures, including intra-uterine insemination and in vitro fertilization, while others hope to improve their chances for conception naturally before moving on to more expensive and complicated strategies. Some patients practice both acupuncture and IUI/IVF at the same time. For 2009, the total rate of pregnancy success of all patients the ACRH treated was 73 percent  By comparison, the American Society for Reproductive Medicine reports an IVF success rate of 29.4 percent per egg retrieval, and a delivery rate of about 30 percent. More research is being done to explore the influence of acupuncture on fertility, as well as the influence of acupuncture paired with IUI/IVF.  Some peer-reviewed studies are finding that acupuncture boosts fertility in both women and men, while some contend that if it has no measurable effect but at least does no harm. It is, however, difficult to assess the effectiveness of a traditional Chinese form of medicine with the strictures of Western research, and more investigation continues to be done.

Most of ACRH’s patients stay with the clinic throughout their pregnancy because, Jania said, the acupuncture treatment also reduces the risk of miscarriage, eases morning sickness, and lessens the chances for a complicated labor.

“Acupuncture treatments help tremendously on so many levels, from beginning to end,” Jania said.

Beyond her vantage as a specialist, Jania speaks from personal experience; she went through IVF when she conceived her first child back when she was just beginning to pursue her career as an acupuncturist. The IVF attempts were “really tough” on her body, Jania said.  Later, when she went back to her endocrinologist to discuss a second pregnancy, she asked what her chances were of conception happening naturally. “None,” she was bluntly told.

Jania went on to an acupuncturist. She and her husband both began taking herbs. With no invasive treatment, she was soon pregnant with her second son – who she calls “my Chinese herb baby.”

“I’ve experienced both sides of the coin,” Jania said, which puts her in a position to better facilitate the experiences of her patients who are navigating both Eastern and Western fertility treatments; she collaborates with a reproductive endocrinologist for patients who are doing both treatments simultaneously.

While infertility causes can rest with people of either sex, Jania’s clientele skews heavily female – at an 80/20 ratio.

“Men are harder,” she said. “Many only come because their wives wanted them to come, though they enjoy it when they’re here.”

Julie Ormonde at Auburn Community Acupuncture, is more straightforward about the skewed gender ratio that she sees mirrored in her own clinic: “Usually men come kicking and screaming—unless the man is really on board with fertility and with having a baby.”

For Ormonde, acupuncture fertility treatment is ultimately about balance. At her clinic, she emphasizes a unique process for each patient, drawing from the information that she can learn by reading temperature charts and cervical mucus.

“Most women have a period and cervical mucus and they don’t pay any attention to it,” Ormonde said. “Is it clotted, bright red, dark red? This tells us an incredible amount of information. … (and) so much in-depth information is needed for fertility treatment because there are so many variables in fertility.”

Her work has convinced her that there is a broad general confusion about how pregnancy even happens.

“Western medicine doesn’t do a lot of teaching about how you get pregnant,” Ormonde said. “Schools don’t do this either. People really don’t know how to get pregnant. They’re never taught how to take control of their cycle; they don’t know about temperature charts and mucus.

“We’re supposed to teach sex ed in classes, but we don’t teach this,” Ormonde added, noting that this same information is meaningful for understanding how not to get pregnant. “A lot of people get pregnant fairly quickly once they learn when to have sex based on their body.”

Ormonde herself came to acupuncture after suffering from narcolepsy. After a long series of Western treatments and specialists, she took a chance on Eastern needles and herbs in 1997. While narcolepsy is considered an incurable disease, Ormonde found quick relief as her sleep patterns stabilized during acupuncture treatment. She hasn’t experienced her former symptoms in the thirteen years since.  Later, when Ormonde was ready for pregnancy, she used acupuncture to regulate her menstrual cycles and was able to facilitate her own fertility.

But despite the potential for acupuncture treatments for infertility, its widespread use as a positive alternative–or perhaps complement–to assisted reproductive technology is hindered by the systematic segregation of acupuncture as viable health care.

Acupuncture is not covered by many health insurance companies for fertility treatments or anything else – making services at traditional clinics, which cost $100-$200 per individual session far too expensive for many people (even though they remain much more affordable than IUI/IVF treatments).

Community acupuncture clinics like Ormonde’s are premised on making this potent form of care accessible and affordable to as many people as possible. In a strategy that may help fill the gap, these clinics offer acupuncture services in a communal setting that are provided on a sliding scale of $15-$45.

“One of my issues with acupuncture was, as an acupuncturist, I could not afford to get it myself,” Ormonde said about her early years practicing in traditional settings.

When she came by the community model of practice, she embraced it. “When I started, there were just a few clinics doing this. Now it’s just blossomed into an incredible movement.”

But even as the community acupuncture movement is developing rapidly—there are more than 120 community clinics across the nation, and the number is growing—large swaths of the United States still don’t have one available to them. Therefore, because of costs, acupuncture is not always a feasible source of care for those struggling with infertility.

Changes in the Medicare bill could alter this; it’s possible the new version of it will include coverage for alternative medicine, including acupuncture.

Congressman Maurice Hinchey (D-NY) has re-introduced legislation every year that he’s been in Congress—since 1993—that would make acupuncture a covered service for the 44 million Americans on Medicare.  When he again brought the bill forward last year, Hinchey said that, “It is entirely unacceptable that Medicare and the Federal Employees Health Benefits program don’t cover acupuncture treatment and thus force plan participants to forego acupuncture or pay for it entirely out of their own pocket … In a country as great as ours no American should ever be denied access to any legitimate forms of medical care that can make them healthier and more comfortable.”

The number of co-sponsors to this bill has steadily increased each year since Hinchey first introduced it. If and when Medicare is adapted to include acupuncture, it will pose a compelling pressure for other health insurance agencies to follow suit and expand their coverage to do the same.

Another obstacle to widespread acceptance of acupuncture as a viable fertility treatment comes down to simple fear of needles, according to Jania.

“It’s a huge barrier,” said Jania of this fear. “People have a scary image in their minds, but (we don’t use) hypodermic needles; our needles are about the size of a hair.”

Nonetheless, misconceptions about acupuncture needling as an ominous or painful treatment may compel many to avoid it and ironically, to turn to riskier and more invasive infertility procedures.

In addition, acupuncture is an infertility treatment that requires a certain amount of patience—another turn-off for some people who are anxious for pregnancy.

“Western medicine is fabulous at taking something and forcing it to happen,” Ormonde said. “Chinese medicine is about re-balancing the body to help the body get pregnant naturally. That takes time. I can’t give it to you in one month.”

It takes an average of six months for people receiving acupuncture treatment to become pregnant. If time truly is short—that is, depending on the age and medical history of the patient—Ormonde may recommend simultaneous treatment with Western fertility clinics. These clinics she noted, are becoming more receptive and respectful to her own work as they see positive outcomes from acupuncture.

The effectiveness of acupuncture can’t be well put to standard Western proofs. While Western medicines are often tested in standardized double-blind studies, there is no clear way to similarly apply scientific controls to test acupuncture. At the same time, the nature of the practice resists formula; each treatment is very much personalized, making generalizations from test results somewhat futile.

There is no single acupuncture prescription for infertility; even as there are common elements in the treatment process, it is always uniquely tailored to the biology and needs of each patient. Auburn Community Acupuncture offers an FAQ section on its website that provides responses to questions about how acupuncture can influence fertility, specifically enumerating the reproductive issues that it can be used for, from endometriosis to irregular menstrual cycles to recurrent miscarriage.

Ormonde noted that if acupuncture didn’t work, it’s unlikely it would have been around for as many years as it has.

“Things don’t last 5000 years if they don’t work,” she said.

Jania echoed this idea – and suggested that acupuncture may be that it is due for a surge of popularity, having no less of a mainstream endorsement than Dr. Oz.

“It’s hard for me to explain the passion I feel for this medicine,” Jania said. “It has save me time and time again. I wish more people experienced it.”

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  • cactuar-tamer

    It is hard to articulate how disappointed I am to see an article like this on a website who’s work I otherwise respect greatly.

     

    Acupuncture and other sorts of ‘alternative’ medicines are not supported by the strong peer-reviewed studies, with large sample sizes and placebo controls, that ought to precede any sort of medical procedure being implemented.

     

    The article itself offers no specific reference to any peer-reviewed study, indeed, the article admits that ‘some’ of the patients in question are trying both treatments at the same time. Right away we realize the two groups which are ostensibly being compared are not mutually exclusive. Furthermore, we are not made aware of the respective sample sizes or whether there was any attempt to utilize any demographic controls. The data which is provided is shaky at best, and heavily girded by anecdote. Not once is anyone not already partial to acupuncture quoted in this article.

     

    In the best of cases, the success rate is equal to the placebo effect, and in the worst cases harm is done either by unregulated practices (unclean needles causing infection), or by someone seeking acupuncture instead of real medicine for a serious condition. Articles like this which contribute to the legitimacy of these practices are no better than supporting the anti-vaccination movement.

     

    The article itself is shockingly uncritical, blithely defining ‘qi’ as if there was any solid evidence for it’s existence. The level of logical fallacy contained in lines such as “Ormonde noted that if acupuncture didn’t work, it’s unlikely it would have been around for as many years as it has,” is also staggering.

     

    The uncritical tone of support towards Congressman Hinchey’s legislation is also unfortunate. It would be terrible indeed, if health care were to offer coverage for treatment not judged effective by scientific consensus.  Does the author also support Representative Shimkus’s attempt to include coverage for prayer healing, such as the sort that frequently causes the death-by-medical-neglect of young children in certain Christan traditions?

     

    I don’t expect to convince anyone who is a true believer in this sort of thing, but I felt the point had to be made. Lending legitimacy to things like this endangers the lives and health of others.

     

  • elizabethk

    I am delighted to read about legislation that would allow for acupuncture treatments under Medicare. As someone who struggled with infertility, I found Western medicine’s approach to infertility to be impersonal and overly scientific. There was no consideration of my particular condition and why I was having trouble getting pregnant. A few standard tests determined that I had “unexplained infertility,” and I was prescribed the same invasive treatments as everyone else. When these didn’t work and the fertility drug I was taking caused ovarian cysts, I decided to try acupuncture and chinese herbs. In stark contrast to my experience at the fertility clinic, my acupuncturist considered my physical condition and the reasons for my infertility. She looked at me as an individual and made specific dietary and exercise recommendations based on my condition. After four months of acupuncture treatments and one month of chinese herbs, my husband and I conceived a child naturally (this, after two years of trying). Acupuncture treated the cause of my problem, not the symptom, which is why I believe it was so successful. I echo Candace Jania’s sentiment – I wish more people could experience it.

  • ebuchen

    I am all for supporting noninvasive and inexpensive “alternative” treatments, but as Cactuar Tamer pointed out, these treatments are difficult to study (you can’t do a blinded randomization with acupuncture).  On the one hand, if it works, whether or not it’s placebo effect, what’s the harm?  On the other, these clinics may be doing false advertising when they claim success rates of 73% because most of the women – as the article states – are not truly infertile but simply “looking to enhance their fertility,” which means they would likely have conceived eventually with no intervention at all.

  • zangfuqi

    We should picket acupuncture clinics around the world and let their success story patients know that they made a big mistake because acupuncture has not been proven in peer reviewed double-blind clinical trial (which only really works for pharmaceuticals anyway).  They should go back to the western doctor they had previously and keep trying, the proven way, until it works for them.

     

    If you can’t conduct peer reviewed double-blind clinical trial of acupuncture (how can the practitioner be blinded?  I don’t know one acupuncturist that can’t tell if they’ve given someone real acupuncture or “sham acupuncture”) then no one has proven that acupuncture doesn’t work either.  Patients feeling better is the only proof that an acupuncturist needs or cares about…..regardless of what the mechanism is.

    Cactuar, please show me proof that there’s any significant number of cases of people getting infected by acupuncture needles or any significant number of cases of people ignoring serious conditions and choosing to go to acupuncturist before going to a western doctor?

  • anna-clark

    If you are interested in the medical research on acupuncture, you might want to start here:

     

    From the NIH: http://nccam.nih.gov/research/results/spotlight/020808.htm

     

    From the British Medical Journal: http://www.google.com/search?q=acupuncture+fertility+medical+study&hl=en&client=firefox-a&hs=KHo&rls=org.mozilla:en-US:official&start=50&sa=N

     

    A Cornell University study, “Role of Acupuncture in the Treatment of Female Infertility,” published in the December, 2002 issue of the medical journal Fertility & Sterility.

     

    “Influence of Acupuncture on the Pregnancy Rate in Patients Who Undergo Assisted Reproduction Therapy.” (2002)

     

    “Effect of Acupuncture on the Outcome of in vitro Fertilization and Intracytoplasmic Sperm Injection: a Randomized, Prospective, Controlled Clinical Study.”

     

    There are many more, including many being explored now, but as I mention in the article, this unusualness of acupuncture compared to most forms of medicine/healing practice makes it uncommonly difficult to place into the typical research format.

     

    Also, you might be interested in knowing that acupuncturists don’t re-use needles; I hope the fact that they use entirely new needles, unwrapped for the first time in front of the patient, addresses your concern about dirty needles.

    Thanks very much for your interest.

  • bbcaddict

    Being a good skeptic I’ve actually tried acupuncture – several times and had NO reasult at all from it. Much like homeopathy, it’s one of those pseudo-reliefs that certain people seems to crow about (maybe it works for them and them only which is one reason to have clinical trials – we have a trial on MEDITATION right now so it IS possible to have trials on acupuncture) and it doesn’t work for the majority.

    I certainly think that the placebo effect is at work with a lot of people who say that acupuncture has “worked” or “cured” them of a condition.

     

  • bshen

    The comments about the “dangers” of acupuncture are completely unfounded. Acupuncture performed by a licensed practitioner is an extremely safe procedure. In the US, acupuncturists are trained in and required to use Clean Needle Technique which was designed to ensure that every precaution is taken to ensure patient safety, only pre-sterilized disposable needles are used.  

     

     

    A large part of an acupuncturist’s education is training in western medicine for the purpose of recognizing potentially serious medical conditions and knowing when to refer to an MD.  The reality is most people who go to an acupuncturist have already seen a medical doctor, and in some cases they have seen a long list of medical doctors and specialists, they end up going to an acupuncturist because modern medicine has no more to offer them.  Ethical acupuncturists will work in conjunction with your MD, they would never recommend stopping medical care, comparing acupuncture to “prayer healing” is ridiculous.

     

     

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