Original article
A case series of acupuncture treatment for female infertility with some cases supplemented with Chinese medicines

https://doi.org/10.1016/j.eujim.2014.03.007Get rights and content

Abstract

Introduction

Delayed marriage is a prominent trend among Chinese citizens in Hong Kong. Such substantial delays expectedly postpone the age of pregnancy, to the extent that aging has become a risk factor for female infertility. There are many underlying reasons for female infertility. Acupuncture has been used in traditional Chinese medicine (TCM) and is suggested to be effective for treating infertility. The objective of this study was to observe the outcome of acupuncture treatment on infertile females with some cases supplemented with CM.

Materials and methods

In this case series, female patients who sought medical consultations for infertility were clinically observed. They were treated either with acupuncture alone or with prescriptions of Chinese medicines (CM), based on individual's condition and/or pathogenesis of the disease. There was no obvious major cause of infertility in terms of Western medical diagnosis, yet 15 patients were classified as having “Stagnation of Liver qi” according to Chinese medicine diagnosis theory. Twenty-one patients who completed the course of treatment were studied. Eight patients were treated with acupuncture only, while the remaining 13 patients received acupuncture treatment supplemented with CM.

Results

Over a period of two years there were 14 women who were successful in becoming pregnant (66.7%) and 7 patients were not yet pregnant upon termination of treatment. None of the 21 cases exhibited any adverse effects.

Conclusion

These observations suggest that acupuncture, either with or without CM supplementation, could be an effective option for treating infertility.

Introduction

Delayed marriage is a prominent trend among Chinese citizens in Hong Kong. Mean ages at marriage were 29.7 and 27.1 years respectively for men and women in 1986, with corresponding increases to 33.3 and 30.8 years in 2006 [1]. Such substantial delays expectedly postpone the age of pregnancy, to the extent that aging has become a risk factor for female infertility [2]. Although there has been a downward trend on birth rate in Hong Kong over the last decade [1], there are still a significant number of couples who marry at an older age and who seek assistance for conception.

Female infertility is defined as no conception within 1 year with unprotected intercourse during the fertile phase of menstrual cycles [3]. Secondary infertility is similar but the patient has previously given birth at least once. There are many underlying reasons for female infertility. Treatments include medications and sometimes employing hormones for induction of ovulation. Surgical techniques are commonly used too. However, most of the treatment strategies incur significant discomfort, side-effects and are sometimes invasive [4]. Acupuncture has been used in traditional Chinese medicine (TCM) and is suggested to be effective for treating infertility [5]. Acupuncture may mediate the release of neurotransmitters, which may in turn stimulate secretion of gonadotrophin releasing hormone, thereby influencing the menstrual cycle, ovulation and fertility [6]. It may stimulate blood flow to the uterus by inhibiting uterine central sympathetic nerve activity [6]. Also, acupuncture may stimulate the production of endogenous opioids, which may inhibit the central nervous system outflow and the biological stress response [6]. A recent review concluded that acupuncture can improve the outcome of IVF and the mechanisms may be related to the increased levels of depression, anxiety and stress [5], [7]. This was a case series and the aim of the present study was to observe the outcome of acupuncture on infertile females in the local context with some cases supplemented with TCM prescription medicines. Nevertheless, acupuncture was the main treatment and use of CM was only an adjunct therapy that was used as appropriate for helping the acupuncture.

Section snippets

Subjects

This study took place from October 2004 to June 2009. It was approved by the Clinical Research Ethics Committee of the Macau University of Science and Technology, Macau (MUST), and conducted at the clinics of Modern TCM Ltd. (MTCM) in Hong Kong, which is an affiliation of MUST in Hong Kong. Female patients with infertility problem visiting MTCM were observed and followed up for the study as part of their normal treatment with informed written consent. The diagnosis of infertility was made

Results

A total of 21 patients were recruited and completed the 24-month treatment period. Patients’ ages ranged from 31 to 39 years, with an overall mean of 35.5 years and median of 35 years. Table 1 shows the age and body mass index (BMI) of individual patient at the entry of the study. The period of infertility for these patients ranged from 2 to 10 years (mean = 4.2 years). Eighteen of the 21 patients (85.7%) were diagnosed as having primary infertility, while three (14.3%) were defined as having

Discussion

Female infertility is a common gynecological problem with multiple pathogenesis. It may originate from dysfunction of the uterus, oviduct or ovulation. It is estimated that the infertility rate is about 15% among women at the child-bearing age [11]. It has been suggested that acupuncture moderates the hypothalamic-pituitary-ovarian axis and hence modulates the menstrual cycle. The β-endorphin induced by acupuncture influences the release of gonadotropin-releasing hormone (GnRH), which in turn

Funding

The authors have declared that no financial support was received for this research.

Conflict of interest

The authors have declared that there are no conflict of interest.

References (17)

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