Traditional Chinese Medicine And Infertility - Part Ii
By Dr. Mike Berkley, Thu Dec 8th

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INFERTILITY AND TRADITIONAL CHINESE MEDICINE PART II

In Part I, we considered the proper treatment methods ofTraditional Chinese Medicine and The Four Examinations,whichdate back over three thousand years.

In this section, we will look at the mechanisms of action ofTraditional Chinese Medicine.

It was shown in a study done at Harvard that stress reduces thehypothalamic-anterior pituitary-ovarian axis function, thusbeing a factor to be considered in the work-up.Acupuncture releases endorphins which mitigate ones response tostressful stimuli thus enhancing the possibility for conception.

"Historically, infertility, particularly "functional"infertility, was attributed to abnormal psychologicalfunctioning on the part of one or both members of the couple.Preliminary works in the 1940s and 1950s considered "psychogenicinfertility" as the major cause of failure to conceive in asmany as 50% of cases. As recently as the late 1960s, it wascommonly believed that reproductive failure was the result ofpsychological and emotional factors. Psychogenic wassupposed to occur because of unconscious anxiety about sexualfeelings, ambivalence toward motherhood, unresolved oedipalconflict, or conflicts of gender identity. Fortunately, advancesin reproductive endocrinology and medical technology as well asin psychological research have de-emphasized the significance ofpsychopathology as the basis of infertility, and modern researchshows that there is little evidence to support a role forpersonality factors or conflicts as a cause of infertility. Thisperspective unburdens the couple by relieving them of theadditional guilt of thinking that it is their mental stress thatmay be responsible for their infertility.

Biologically, since the hypothalamus regulates both stressresponses as well as the sex hormones, it's easy to see howstress could cause in some women. Excessive stressmay 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 causeanovulation or irregular menstrual cycles. When activated bystress, the pituitary gland also produces increased amounts ofprolactin, and elevated levels of prolactin could causeirregular ovulation. Since the female reproductive tractcontains catecholamine receptors catecholamines produced inresponse to stress may potentially affect fertility, forexample, by interfering with the transport of gametes throughthe Fallopian tube or by altering uterine blood flow. However,more complex mechanisms may be at play, and researchers stilldon't completely understand how stress interacts with thereproductive system. This is a story, which is still unfolding,and during the last 20 years, the new field ofpsychoneuroimmunology has emerged, which focuses on how yourmind can affect your body.

Research has shown that the brain produces special moleculescalled neuropeptides, in response to emotions, and thesepeptides can interact with every cell of the body, includingthose of the immune system. In this view, the mind and the bodyare not only connected, but also inseparable, so that it ishardly surprising that stress can have a negative influence onfertility.

Stress can reduce sperm counts as well. Thus, testicularbiopsies obtained from prisoners awaiting execution, who wereobviously under extreme stress, revealed completespermatogenetic arrest in all cases. Researchers have alsoshowed significantly lower semen volume and sperm concentrationin a group of chronically stressed marmoset monkey, and thesechanges were attributed to lower concentrations of LH andtestosterone (which were reduced in the stressed group).However, how relevant these research findings are in clinicalpractice is still to be determined."

The stress factors that acupuncture addresses stems from bothpsycho-emotional factors as well as physical etiologies. Forexample, extremely painful pre-menstruum or mid cycle pain canbe debilitating. This type of physical stress, no doubt producesemotional stress as a result of missed work, manifest pain andother life-style factors resulting from such extreme pain; allcan mitigate the function of the reproductive system.

Aceto corticotropic hormone is released as a response toacupuncture needle stimuli. ACTH has an antiinflammatorymechanism

which may for example, help with tubal factor basedinfertility as a response to pelvic inflammatory disease.

The insertion of acupuncture needles has been shown toeffectively increase blood circulation. Acupuncture is veryeffective in treating, for example, Reynaud's Syndrome. Enhancedmicrocirculatory patency to the uterine lining does, undoubtedlycontribute to a healthier and more growth oriented endometrium,especially when utilizing electrical stimulation on insertedacupuncture needles on points known as zigongxue which residesuperior to the ovaries. The points zigongxue are located 3inches inferior to the umbilicus and three inches bilateral tothe anterior midline.

"They reviewed existing evidence regarding the role ofacupuncture in the treatment of infertility, and identified anumber of studies indicating that acupuncture can be beneficialas an adjunct to other treatments, including IVF.Only one randomized controlled study examined the independenteffect of acupuncture on IVF outcomes, but this indicated apositive effect.

The reviewed authors also highlight evidence that shows theeffects of acupuncture may be mediated through neuropeptidesthat influence gonadotropin secretion, which could in turnaffect the menstrual cycle. The technique can also reducestress, which is known to adversely affect fertility, and hasbeen implicated in the regulation of uterine blood flow."

"Using acupuncture during assisted reproduction may improvepregnancy rates, say researchers. However, they acknowledge thatthe mechanism behind this effect is unclear, and the team plansto carry out further studies to confirm, and furtherinvestigate, their findings.

Noting that acupuncture has been shown to affect the autonomicnervous system, Dr. Wolfgang Paulus(Christian-Lauritzen-Institut, Ulm, Germany) and colleaguespostulated that the therapy could increase endometrialreceptivity via control of related muscles and glands.

The researchers randomly assigned 160 women receiving assistedreproductive therapy to undergo IVF with or without acupuncture,before and after embryo transfer. In acupuncture subjects, theneedles were placed at points believed to influence reproductivefactors, for example by improving blood flow to the uterus.

Paulus et al report that the acupuncture group had a higher rateof pregnancy compared with those not given acupuncture (43percent versus 26 percent). They conclude, therefore, thatacupuncture could be "a useful tool" for improving pregnancyrates during certain treatments."

In Part III we will look at the combined elements of Eastern andWestern medicine along with herbal medication in the treatmentof infertility.

About the author:Dr. Mike Berkley has been treating fertility disorders since1996 with amazing results. He works exclusively in the area ofreproductive medicine and enjoys working in conjunction withsome of New York’s most prestigious reproductiveendocrinologists. Sign up for his free newsletter atwww.BerkleyCenter.com