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Traditional
Chinese Medicine and Infertility
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by:
Dr. Mike Berkley
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INFERTILITY AND TRADITIONAL CHINESE MEDICINE PART II
In Part I, we considered the proper treatment methods of Traditional
Chinese Medicine and The Four Examinations,which date back over three
thousand years.
In this section, we will look at the mechanisms of action of
Traditional Chinese Medicine.
It was shown in a study done at Harvard that stress reduces the
hypothalamic-anterior pituitary-ovarian axis function, thus being a
factor to be considered in the infertility work-up. Acupuncture
releases endorphins which mitigate ones response to stressful stimuli
thus enhancing the possibility for conception.
"Historically, infertility, particularly "functional" infertility, was
attributed to abnormal psychological functioning on the part of one or
both members of the couple. Preliminary works in the 1940s and 1950s
considered "psychogenic infertility" as the major cause of failure to
conceive in as many as 50% of cases. As recently as the late 1960s, it
was commonly believed that reproductive failure was the result of
psychological and emotional factors. Psychogenic infertility was
supposed to occur because of unconscious anxiety about sexual feelings,
ambivalence toward motherhood, unresolved oedipal conflict, or
conflicts of gender identity. Fortunately, advances in reproductive
endocrinology and medical technology as well as in psychological
research have de-emphasized the significance of psychopathology as the
basis of infertility, and modern research shows that there is little
evidence to support a role for personality factors or conflicts as a
cause of infertility. This perspective unburdens the couple by
relieving them of the additional guilt of thinking that it is their
mental stress that may be responsible for their infertility.
Biologically, since the hypothalamus regulates both stress responses as
well as the sex hormones, it's easy to see how stress could cause
infertility in some women. Excessive stress may even lead to complete
suppression of the menstrual cycle, and this is often seen in female
marathon runners, who develop "runner's amenorrhea". In less severe
cases, it could cause anovulation or irregular menstrual cycles. When
activated by stress, the pituitary gland also produces increased
amounts of prolactin, and elevated levels of prolactin could cause
irregular ovulation. Since the female reproductive tract contains
catecholamine receptors catecholamines produced in response to stress
may potentially affect fertility, for example, by interfering with the
transport of gametes through the Fallopian tube or by altering uterine
blood flow. However, more complex mechanisms may be at play, and
researchers still don't completely understand how stress interacts with
the reproductive system. This is a story, which is still unfolding, and
during the last 20 years, the new field of psychoneuroimmunology has
emerged, which focuses on how your mind can affect your body.
Research has shown that the brain produces special molecules called
neuropeptides, in response to emotions, and these peptides can interact
with every cell of the body, including those of the immune system. In
this view, the mind and the body are not only connected, but also
inseparable, so that it is hardly surprising that stress can have a
negative influence on fertility.
Stress can reduce sperm counts as well. Thus, testicular biopsies
obtained from prisoners awaiting execution, who were obviously under
extreme stress, revealed complete spermatogenetic arrest in all cases.
Researchers have also showed significantly lower semen volume and sperm
concentration in a group of chronically stressed marmoset monkey, and
these changes were attributed to lower concentrations of LH and
testosterone (which were reduced in the stressed group). However, how
relevant these research findings are in clinical practice is still to
be determined."
The stress factors that acupuncture addresses stems from both
psycho-emotional factors as well as physical etiologies. For example,
extremely painful pre-menstruum or mid cycle pain can be debilitating.
This type of physical stress, no doubt produces emotional stress as a
result of missed work, manifest pain and other life-style factors
resulting from such extreme pain; all can mitigate the function of the
reproductive system.
Aceto corticotropic hormone is released as a response to acupuncture
needle stimuli. ACTH has an antiinflammatory mechanism which may for
example, help with tubal factor based infertility as a response to
pelvic inflammatory disease.
The insertion of acupuncture needles has been shown to effectively
increase blood circulation. Acupuncture is very effective in treating,
for example, Reynaud's Syndrome. Enhanced microcirculatory patency to
the uterine lining does, undoubtedly contribute to a healthier and more
growth oriented endometrium, especially when utilizing electrical
stimulation on inserted acupuncture needles on points known as
zigongxue which reside superior to the ovaries. The points zigongxue
are located 3 inches inferior to the umbilicus and three inches
bilateral to the anterior midline.
"They reviewed existing evidence regarding the role of acupuncture in
the treatment of infertility, and identified a number of studies
indicating that acupuncture can be beneficial as an adjunct to other
infertility treatments, including IVF. Only one randomized controlled
study examined the independent effect of acupuncture on IVF outcomes,
but this indicated a positive effect.
The reviewed authors also highlight evidence that shows the effects of
acupuncture may be mediated through neuropeptides that influence
gonadotropin secretion, which could in turn affect the menstrual cycle.
The technique can also reduce stress, which is known to adversely
affect fertility, and has been implicated in the regulation of uterine
blood flow."
"Using acupuncture during assisted reproduction may improve pregnancy
rates, say researchers. However, they acknowledge that the mechanism
behind this effect is unclear, and the team plans to carry out further
studies to confirm, and further investigate, their findings.
Noting that acupuncture has been shown to affect the autonomic nervous
system, Dr. Wolfgang Paulus (Christian-Lauritzen-Institut, Ulm,
Germany) and colleagues postulated that the therapy could increase
endometrial receptivity via control of related muscles and glands.
The researchers randomly assigned 160 women receiving assisted
reproductive therapy to undergo IVF with or without acupuncture, before
and after embryo transfer. In acupuncture subjects, the needles were
placed at points believed to influence reproductive factors, for
example by improving blood flow to the uterus.
Paulus et al report that the acupuncture group had a higher rate of
pregnancy compared with those not given acupuncture (43 percent versus
26 percent). They conclude, therefore, that acupuncture could be "a
useful tool" for improving pregnancy rates during certain infertility
treatments."
In Part III we will look at the combined elements of Eastern and
Western medicine along with herbal medication in the treatment of
infertility.
About the Author
Dr. Mike Berkley has been treating fertility
disorders since 1996 with amazing results. He works exclusively in the
area of reproductive medicine and enjoys working in conjunction with
some of New York’s most prestigious reproductive endocrinologists. Sign
up for his free newsletter at www.BerkleyCenter.com
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