Clinical studies on the mechanism for acupuncture stimulation of ovulation
Mo X; Li D; Pu Y; Xi G; Le X; Fu Z Zhejiang College of Traditional Chinese Medicine, Hangzhou.

Ovulatory dysfunction is commonly seen in gynecology clinic. It may cause infertility, amenia, functional uterine bleeding and a variety of complications. This research according to TCM theory records treating with acupuncture 34 patients suffering from ovulatory dysfunction. Changes in clinical symptoms and some relative targets are reported, plus findings in animal experiments. The theory concerning the generative and physiologic axis of women, this research involved the following points; Ganshu (UB 18), Shenshu (UB 23), Guanyuan (Ren 4), Zhongji (Ren 3), and Sanyinjiao (Sp 6). The reinforcement and reduction of acupuncture enables it to strengthen liver and kidney. Through the Chong and Ren channels it nourishes uterus to adjust the patient’s axis function and recover ovulation. Treated on an average of 30 times, the patients’ symptoms improved to varying degrees. The marked effective rate was 35.29%, the total effective rate being 82.35%. BBT, VS, CMS, and B ultrasonic picture all improved to some degree. The results also showed that acupuncture may adjust FSH, LH, and E2 in two directions and raise the progesterone level, bringing them to normal. The animal experiments confirmed this result. Results showed that acupuncture may adjust endocrine function of the generative and physiologic axis of women, thus stimulating ovulation. The results of this research will provide some scientific basis for treating and further studying this disorder.

Relationship Between Blood Radioimmunoreactive Beta-Endorphin and Hand Skin Temperature During The Electro-Acupuncture Induction of Ovulation

By Chen Bo Ying M.D. Lecturer of Neurobiology
Institute of Acupuncture Research, and Yu Jin, MD., Prof of Gynecology Obstetricus and Gynecology Hospital Shanghai Medical University Shanghai, People’s Republic of China

Abstract:

Thirteen cycles of anovulation menstruation in 11 cases were treated with Electro-Acupuncture (EA) ovulation induction. In 6 of these cycles which showed ovulation, the hand skin temperature (HST) of these patients was increased after EA treatment. In the other 7 cycles ovulation was not induced. There were no regular changes in HST of 5 normal subjects. The level of radioimmunoreactive beta-endorphin (rß-E) fluctuated, and returned to the preacupunctural level in 30 min. after withdrawal of needles in normal subjects. After EA, the level of blood rß-E in cycles with ovulation declined or maintained the range of normal subjects. But the level of blood rß-E and increase of HST after EA (r=-0.677, P <0.01). EA is able to regulate the function of the hypothalamic pituitary-ovarian axis. Since a good response is usually accompanied with the increase of HST, monitoring HST may provide a rough but simple method for prediciting the curative effect of EA. The role of rß-E in the mechanism of EA ovulation induction was discussed.

KEYWORDS: Electro-Acupuncture (EA), Hand Skin Temperature (HST), radioimmunoreactive beta-endorphin (rß-E), ovulation, radioimmunoassay (RIA).
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fertility and sterility acupuncture Acupuncture Treatment For Infertile Women Undergoing Intracytoplasmic Sperm injection
Sandra L. Emmons, MD
Phillip Patton, MD

Source: Medical Acupuncture, A Journal For Physicians By Physicians
Spring / Summer 2000- Volume 12 / Number 2
“Aurum Nostrum Non Est Aurum Vulgi”

Table 1. Outcomes for Acupuncture vs Non-Acupuncture Cycles Among 6 Women Undergoing ICSI*
Patient No.
Age, y
Non-Acupuncture Cycles
AcupunctureCycles
Follicles Cycles Follicles Cycles
Mean No. No. Mean No. No. Outcome
1 29 4.7 3 8 1 IUP
2 34 2 1 10 2 SAB twice
3 36 3 2 14 1 SAB
4 37 8 1 6 1 No pregnancy
5 38 1 1 4 1 Cycle canceled
6 41 2 1 6 1 SAB
Mean (SD) 3.7 (1.0) 8.4 (1.3)
*ICSI indicates intracytoplasmic sperm injection; IUP, intrauterine pregnancy; and SAB, early spontaneous abortion. P=.02 for overall acupuncture follicles vs non-acupuncture follicles.

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ugelscriftforlaeger-infertility-acupuncturelA retrospective analysis of the results of obstetric acupuncture at Frederiksberg Hospital
[Article in Danish]
Spellerberg E, Smidt-Jensen SL.

Fodeafdelingen, H:S Frederiksberg Hospital, DK-2000 Frederiksberg. eileen@spellerberg.net

INTRODUCTION: The use of obstetric acupuncture in Denmark is increasing but its use in routine clinical practice has not been evaluated. MATERIAL AND METHODS: This retrospective uncontrolled study comprises 691 women who attended Frederiksberg Hospital during pregnancy and delivery. Their mean age was 30.5 +/- 4.3 year, mean parity 1.3 +/- 0.6 (71.8% were primiparous), and the mean gestational age was 39 +/- 3.7 weeks. A total of 563 of the women (81.5%) were in labour. The effect of acupuncture was evaluated by the pregnant women alone for the pregnancy-related indications and by both women and midwifes for labour-related indications. RESULTS: The women had acupuncture based on 997 individual indications (mean 1.4 +/- 0.5). Twenty-two indications were used. 78.8% of all treatments were for pain relief or anxiety. The scores were highly correlated between women and midwives as 42.2 and 40.6%, respectively, indicated “full effect” and 33.3 and 33.4% indicated “some effect”. The midwives’ scores were independent of the women’s age, parity, gestational age and indication(s). One possible side effect was observed (temporary dropfoot). DISCUSSION: In this study, routine obstetric acupuncture was perceived as equally effective by the women and midwifes. The method is simple, inexpensive and without significant adverse effects. It deserves a place in the midwives’ armamentarium.

Ugeskr Laeger. 2003 Mar 3;165(10):1023-7.

ajo-infertility-acupuncture1 The use of complementary medicine and therapies by patients attending a reproductive medicine unit in South Australia: A prospective survey
Marcin STANKIEWICZ 1, Caroline SMITH 2, Helen ALVINO 3 and Robert NORMAN 4

1Department of Obstetrics Gynaecology and Reproductive Medicine, Flinders Medical Centre, 2Discipline of Obstetrics and Gynaecology, School of Paediatrics and Reproductive Health, The University of Adelaide, 3Adelaide Hormone and Menopause Centre, Adelaide Fertility Centre Pty Ltd, and 4Discipline of Obstetrics and Gynaecology, Medical School North, The University of Adelaide, South Australia, Australia
Correspondence: Dr Marcin Stankiewicz, Flinders Reproductive Medicine Unit, Department of Obstetrics Gynaecology and Reproductive Medicine, Flinders Medical Centre, Flinders Drive, Bedford Park, SA 5042, Australia. Email: marcin.stankiewicz@fmc.sa.gov.au
Key words : complementary therapies, reproductive techniques assisted, in vitro fertilisation, female infertility, male infertility, vitamins.

DOI: 10.1111/j.1479-828X.2007.00702.x
Abstract

Background: There is limited research describing the use of complementary medicines (CM) and therapies among patients with infertility.

Objective: (i) To examine the use of CM by subjects attending an infertility clinic at their first consultation and six months later; (ii) to examine men’s and women’s views on the effectiveness and safety of these practices; and (iii) to examine the documentation of the use of CMs and therapies in clinical notes.

Design: A prospective survey of 100 consecutive new patients presenting to an infertility clinic. Subjects were requested to complete a self-administered questionnaire at their first visit and six months later. A retrospective audit of 200 patient records.

Results: A response rate of 72% was obtained. Sixty-six percent of patients attending the infertility clinic in South Australia used CMs. Six months following the initial consultation the use of CMs had declined. The most commonly used CMs included multivitamins, herbs, and mineral supplements, and subjects consulted most frequently with naturopaths, chiropractors and acupuncturists. The use of CMs and therapies was poorly documented by clinical staff.

Conclusion: Complementary medicines and therapies are widely used by patients with infertility. Health-care practitioners and fertility specialists need to be proactive in acquiring and documenting the use of these practices. There is a need to provide further information to patients on the use of CMs and therapies. Further research examining the reasons for use of CMs and therapies is needed.

The Australian and New Zealand Journal of Obstetrics and Gynaecology

Volume 47 Issue 2 Page 145 – April 2007

Marcin STANKIEWICZ, Caroline SMITH, Helen ALVINO, Robert NORMAN (2007)
The use of complementary medicine and therapies by patients attending a reproductive medicine unit in South Australia: A prospective survey
The Australian and New Zealand Journal of Obstetrics and Gynaecology 47 (2), 145–149.
doi:10.1111/j.1479-828X.2007.00702.x

Using acupuncture to treat premenstrual syndrome.
Habek D, Habek JC, Barbir A.

Department of Gynecology and Obstetrics, Health Centre, Bjelovar, Croatia. dubravko.habek@bj.hinet.hr

More than 60% of the women in both groups suffered from premenstrual syndrome (PMS or PMT) symptoms, such as anxiety, mastalgia, insomnia, nausea and gastrointestinal disorders, whereas a smaller number of women suffered from phobic disorders, premenstrual headaches and migraines. There were three women from the first group and seven women from the second group who continued the medication treatment with progestins, whereas one woman from the first group and nine women from the second group continued to take fluoxetine. In the first group, nine women stopped having PMS symptoms after two AP treatments, eight women stopped having them after three treatments and one woman stopped having them after four treatments. In four women from the first group and 16 women from the second group, PMS symptoms appeared during the following period (cycle) or continued even after four treatments, so the medication was continued. In the first group, one woman had a smaller subcutaneous hematoma after the AP acupoint Ren 6. There was a statistical and relevant reduction in PMS symptoms with the AP treatments in the first group (P<0.001), whereas their reduction was irrelevant in the placebo AP group (P>0.05). The success rate of AP in treating PMS symptoms was 77.8%, whereas it was 5.9%. in the placebo group. The positive influence of AP in treating PMS symptoms can be ascribed to its effects on the serotoninergic and opioidergic neurotransmission that modulates various psychosomatic functions. The initial positive results of PMS symptoms with a holistic approach are encouraging and AP should be suggested to the patients as a method of treatment.

Arch Gynecol Obstet. 2002 Nov;267(1):23-6.

Electroacupuncture: mechanisms and clinical application.
Ulett GA, Han S, Han JS.

University of Missouri-Columbia, School of Medicine, St. Louis 63139, USA.

Acupuncture is an ancient Chinese method to treat diseases and relieve pain. We have conducted a series of studies to examine the mechanisms of this ancient method for pain relief. This article reviews some of our major findings. Our studies showed that acupuncture produces analgesic effect and that electroacupuncture (EA) is more effective than manual acupuncture. Furthermore, electrical stimulation via skin patch electrodes is as effective as EA. The induction and recovering profiles of acupuncture analgesia suggest the involvement of humoral factors. This notion was supported by cross-perfusion experiments in which acupuncture-induced analgesic effect was transferred from the donor rabbit to the recipient rabbit when the cerebrospinal fluid (CSF) was transferred. The prevention of EA-induced analgesia by naloxone and by antiserum against endorphins suggests that endorphins are involved. More recent work demonstrated the release of endorphins into CSF following EA. In addition, low frequency (2 Hz) and high frequency (100 Hz) of EA selectively induces the release of enkephalins and dynorphins in both experimental animals and humans. Clinical studies suggesting its effectiveness for the treatment of various types of pain, depression, anxiety, spinally induced muscle spasm, stroke, gastrointestinal disorders, and drug addiction were also discussed.

Biol Psychiatry. 1998 Jul 15;44(2):129-38.

Evidence Based Medicine

We are often asked why some studies are better than others.

This is a complex subject. Apart from the quality, design, and other factors, we have to take into account the different levels of evidence. As you can see from this chart, expert opinion is the weakest evidence and systematic reviews are the strongest.

For example, Acupuncture as an adjunct to IVF has been researched extensively. The big majority of the studies that used good methodology showed that acupuncture was effective. Systematic reviews have summarised those studies and confirmed that acupuncture was an effective therapy to improve IVF success rate. Therefore, one could say that there is a strong evidence supporting acupuncture as an adjunct to IVF.

Should you ask for acupuncture for pain relief during your next egg collection? Can acupuncture replace powerful drugs like alfentanil?

This study authors think that electro-acupuncture stands a good chance to relieve pain during egg collection. It proved to be as good as alfentanil.

Furthermore, compared with the alfentanil group, women in the electro-acupuncture group had a higher implantation rate, more pregnancies. But, what matters the most, they had more babies per embryo transfer as well.

This study was not designed to measure pregnancy rates, we need to be a bit careful with these outcomes. However, it gave an obvious proof that acupuncture can replace drugs during the egg collection.

A prospective randomized study of electro-acupuncture versus alfentanil as anaesthesia during oocyte aspiration in in-vitro fertilization

Elisabet Stener-Victorin, Urban Waldenstra, Lars Nilsson, Matts Wikland and Per Olof Janson

Abstract:

The aim of the present study was to evaluate the anaesthetic effect during oocyte aspiration of a paracervical block (PCB) in combination with either electro-acupuncture (EA) or intravenous alfentanil.

In all, 150 women undergoing in-vitro fertilization (IVF) and embryo transfer were randomized to receive either EA plus PCB or alfentanil plus PCB. Visual analogue scales (VAS) were used to evaluate subjective experiences during oocyte aspiration, and IVF outcome parameters were recorded.

No differences in pain directly related to oocyte aspiration, adequacy of anaesthesia during oocyte aspiration, abdominal pain, or degree of nausea were found between the two groups in the VAS ratings. Before oocyte aspiration, the level of stress was significantly higher in the EA group than in the alfentanil group (P < 0.05), and the EA group experienced discomfort for a significantly longer period during oocyte aspiration (P < 0.01). Compared with the alfentanil group, the EA group had a significantly higher implantation rate (P < 0.05), pregnancy rate (P < 0.05), and take home baby rate (P < 0.05) per embryo transfer.

Conclusion:

In conclusion, EA has been shown to be as good an anaesthetic method as alfentanil during oocyte aspiration, and we suggest that EA may be a good alternative to conventional anaesthesia during oocyte aspiration.

Acupuncture increases nocturnal melatonin secretion and reduces insomnia and anxiety: a preliminary report.
Spence DW, Kayumov L, Chen A, Lowe A, Jain U, Katzman MA, Shen J, Perelman B, Shapiro CM.

Centre for Addiction and Mental Health, Toronto, Ontario, Canada.

The response to acupuncture of 18 anxious adult subjects who complained of insomnia was assessed in an open prepost clinical trial study. Five weeks of acupuncture treatment was associated with a significant (p = 0.002) nocturnal increase in endogenous melatonin secretion (as measured in urine) and significant improvements in polysomnographic measures of sleep onset latency (p = 0.003), arousal index (p = 0.001), total sleep time (p = 0.001), and sleep efficiency (p = 0.002). Significant reductions in state (p = 0.049) and trait (p = 0.004) anxiety scores were also found. These objective findings are consistent with clinical reports of acupuncture’s relaxant effects. Acupuncture treatment may be of value for some categories of anxious patients with insomnia.

J Neuropsychiatry Clin Neurosci. 2004 Winter;16(1):19-28.

Effect of acupuncture treatment on the immune function impairment found in anxious women.
Arranz L, Guayerbas N, Siboni L, De la Fuente M.

Department of Physiology (Animal Physiology II), Faculty of Biological Science, Complutense University of Madrid, Spain.

It is presently accepted that emotional disturbances lead to immune system impairment, and that therefore their treatment could restore the immune response. Thus, the aim of the present work was to study the effect of an acupuncture treatment, designed specifically to relieve the emotional symptoms stemming from anxiety, on several functions (adherence, chemotaxis, phagocytosis, basal and stimulated superoxide anion levels, lymphocyte proliferation in response to phytohemagglutinin A (PHA) and natural killer (NK) activity) of leukocytes (neutrophils and lymphocytes) from anxious women. The acupuncture protocol consisted of manual needle stimulation of 19 acupoints, with each session lasting 30 min. It was performed on 34 female 30-60 year old patients, suffering from anxiety, as determined by the Beck Anxiety Inventory (BAI). Before and 72 hours after receiving the first acupuncture session, peripheral blood samples were drawn. In 12 patients, samples were also collected immediately after the first single acupuncture session and one month after the end of the whole acupuncture treatment, which consisted of 10 sessions during a year, until the complete remission of anxiety. Twenty healthy non-anxious women in the same age range were used as controls. The results showed that the most favorable effects of acupuncture on the immune functions appear 72 hours after the single session and persist one month after the end of the complete treatment. Impaired immune functions in anxious women (chemotaxis, phagocytosis, lymphoproliferation and NK activity) were significantly improved by acupuncture, and augmented immune parameters (superoxide anion levels and lymphoproliferation of the patient subgroup whose values had been too high) were significantly diminished. Acupuncture brought the above mentioned parameters to values closer to those of healthy controls, exerting a modulatory effect on the immune system.

Am J Chin Med. 2007;35(1):35-51.

Acupuncture: Impact on Pregnancy Outcomes in IVF Patients

12th World Congress on Human Reproduction, Venice Italy March 2005

Paul C. Magarelli, M.D., Ph.D., Diane Cridennda, L.Ac.  Mel Cohen, MBA

Abstract

Take-Home babies rates (THB) have been the single most important IVF outcome. Pregnancy rates (PR) can overestimate the expected success of a high-technology treatment for patients and many clinics use PR as a means of marketing their practices. This has caused disillusionment in patients and government regulation (especially in the U.S.).

Each IVF program strives to improve reproductive outcomes (low ectopic rates, low miscarriage rates and improved take-home baby rates – live births). Usually the approach to these improvements changes in IVF protocols, media adjustments in the IVF lab, patient selection, and subtle nudges towards egg donors for poor responders.

Another approach has been the inclusion of alternative medical modalities: acupuncture, massage therapy, stress reduction techniques, herbal medicine. We, and others, have chosen to incorporate Acupuncture into our IVF treatment protocols.

Recently we presented two studies that demonstrated improvements in pregnancy rates in Good and Poor IVF Responders with the inclusion of two specific Acupuncture Protocols (Steiner-Victorin and Paulus et. Al).

In the poor responders’ group we demonstrated a positive adjustment to Poor Responders pregnancy rates (PR) with improvements in PR in the Poor Responders group equivalent to good responders.

In the Good Responders study, we demonstrated a trend towards improved PR (5% above controls, not significant at p < 0.05).

With these observations noted we have continued our investigation and are reporting on reproductive outcomes in all IVF patients treated with Acupuncture compared to those untreated.

Materials and Methods:

In this study, 130 IVF cycles were reviewed in a retrospective fashion. Patients demographics, years infertile, age of male partners, sperm parameters, Day 3 FSH, Pulsatility Indices, Weight, BMI, infertility diagnoses, IVF treatment protocols were statistically similar for both the Controls (C) and Acupuncture (Ac) treatment groups.

All patients that completed an IVF cycle (retrieval, transfer) were included. There were 82 in the C group (non-acupuncture) and 48 in the Ac group. For the C vs. Ac groups, a summary of their statistics are as follows: Mean Age was 32.6 vs. 32.7, Day 3 FSH was 5.5 vs. 6.4, Pulsatility Indices for right and left uterine arteries were 1.5 and 1.2 vs. 1.4 and 1.0; Sperm counts were 69 vs. 67 million/ml; Sperm motility (%) were 48 vs. 53%, and Sperm morphologies were 6 % normal vs. 7%.

Results:

Pregnancy rates for the Ac group were statistically similar, although numerically higher, versus C (50% v 45% at P < 0.05). Ac miscarriage rates (SAB) were statistically lower than the C (8 % vs. 11% at p <0.01). There were no ectopic pregnancies in the Ac group ( P < 0.01). Live Births were significantly better in the Ac v C groups (42% v 38%). A surprising observation was that multiples pregnancies were significantly lower in the Ac vs. C groups (17 % vs. 22%). Average eggs retrieved were statistically similar to 15 vs. 15 for Ac and C respectively.

Conclusions:

IVF programs can significantly improve their IVF outcomes ( PR, THB, SAB and Ectopic) by adding acupuncture protocols, specifically Steiner Victorin and Paulus. Further studies of Traditional Chine Medicine modalities of treatment are underway. We are organizing a multicenter prospective study to confirm our observations.

Clinical study on “jin’s three-needling” in treatment of generalized anxiety disorder
[Article in Chinese]
Luo WZ, Liu HJ, Mei SY.

College of Acupuncture and Massage, Guangzhou University of TCM, Guangzhou.

OBJECTIVE: To study the clinical effect of “Jin’s three-needling” in the treatment of generalized anxiety disorder. METHODS: Fifty-eight patients with generalized anxiety were randomly assigned to two groups equally, the medication group treated with anti-anxiety drugs and the acupuncture group with “Jin’s three-needling”. The treatment course was 6 weeks. The clinical effects were evaluated with Hamilton anxiety scale (HAMA), clinical global impression (CGI), and treatment emergent symptom scale (TESS) before treatment and at the end of 2nd, 4th, 6th week of the treatment course. The concentration of 5-hydroxytryptamine (5-HT) in platelet, and plasma levels of corticosterone (CS) and adrenocorticotropic hormone (ACTH) were measured with high performance liquid chromatography-electrochemical detection (HPLC-ED) method before and after treatment. RESULTS: The clinical effects in the two groups were equivalent, while the adverse reaction found in the acupuncture group was less than that in the medication group (P < 0.05). The platelet concentration of 5-HT and plasma ACTH level decreased significantly in both groups after treatment with insignificant difference between the group (P < 0.05). The plasma CS level had no obvious change in the two groups after treatment as compared with that before treatment respectively. CONCLUSION: "Jin's three-needling" shows similar curative effect on generalized anxiety to routine Western medicine but with less adverse reaction, which may be realized through regulating the platelet 5-HT concentration and plasma ACTH level.

Zhongguo Zhong Xi Yi Jie He Za Zhi. 2007 Mar;27(3):201-3.

fertility and sterility acupuncture Fertil Steril. 2002 Apr;77(4):721-4.

Influence of acupuncture on the pregnancy rate in patients who undergo assisted reproduction therapy.
Paulus WE, Zhang M, Strehler E, El-Danasouri I, Sterzik K.

Department of Reproductive Medicine, Christian-Lauritzen-Institut, Ulm, Germany. paulus@reprotox.de

OBJECTIVE: To evaluate the effect of acupuncture on the pregnancy rate in assisted reproduction therapy (ART) by comparing a group of patients receiving acupuncture treatment shortly before and after embryo transfer with a control group receiving no acupuncture. DESIGN: Prospective randomized study. SETTING: Fertility center. PATIENT(S): After giving informed consent, 160 patients who were undergoing ART and who had good quality embryos were divided into the following two groups through random selection: embryo transfer with acupuncture (n = 80) and embryo transfer without acupuncture (n = 80). INTERVENTION(S): Acupuncture was performed in 80 patients 25 minutes before and after embryo transfer. In the control group, embryos were transferred without any supportive therapy. MAIN OUTCOME MEASURE(S): Clinical pregnancy was defined as the presence of a fetal sac during an ultrasound examination 6 weeks after embryo transfer.

RESULT(S): Clinical pregnancies were documented in 34 of 80 patients (42.5%) in the acupuncture group, whereas pregnancy rate was only 26.3% (21 out of 80 patients) in the control group.

CONCLUSION(S): Acupuncture seems to be a useful tool for improving pregnancy rate after ART.

fertility and sterility acupuncture Quantitative evaluation of spermatozoa ultrastructure after acupuncture treatment for idiopathic male infertility.
Pei J, Strehler E, Noss U, Abt M, Piomboni P, Baccetti B, Sterzik K.

Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China. jianpei99@yahoo.com

OBJECTIVE: To evaluate the ultramorphologic sperm features of idiopathic infertile men after acupuncture therapy. DESIGN: Prospective controlled study. SETTING: Christian-Lauritzen-Institut, Ulm, IVF center Munich, Germany, and Department of General Biology, University of Siena, Siena, Italy. PATIENT(S): Forty men with idiopathic oligospermia, asthenospermia, or teratozoospermia. INTERVENTION(S): Twenty eight of the patients received acupuncture twice a week over a period of 5 weeks. The samples from the treatment group were randomized with semen samples from the 12 men in the untreated control group. MAIN OUTCOME MEASURE(S): Quantitative analysis by transmission electron microscopy (TEM) was used to evaluate the samples, using the mathematical formula based on submicroscopic characteristics. RESULT(S): Statistical evaluation of the TEM data showed a statistically significant increase after acupuncture in the percentage and number of sperm without ultrastructural defects in the total ejaculates. A statistically significant improvement was detected in acrosome position and shape, nuclear shape, axonemal pattern and shape, and accessory fibers of sperm organelles. However, specific sperm pathologies in the form of apoptosis, immaturity, and necrosis showed no statistically significant changes between the control and treatment groups before and after treatment.

CONCLUSION(S): The treatment of idiopathic male infertility could benefit from employing acupuncture. A general improvement of sperm quality, specifically in the ultrastructural integrity of spermatozoa, was seen after acupuncture, although we did not identify specific sperm pathologies that could be particularly sensitive to this therapy.

Fertil Steril. 2005 Jul;84(1):141-7.

Influence of acupuncture on idiopathic male infertility in assisted reproductive technology.
Zhang M, Huang G, Lu F, Paulus WE, Sterzik K.

Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030.

The clinical effects of acupuncture on idiopathic male infertility in sperm parameter and on therapeutic results in assisted reproductive technology were investigated. 22 patients failed in intracytoplasmic sperm injection (ICSI) with idiopathic male infertility were treated with acupuncture twice weekly for 8 weeks, followed by ICSI treatment again. The sperm concentration, motility, morphology, fertilization rates and embryo quality were observed. Quick sperm motility after acupuncture (18.3% +/- 9.6%) was significantly improved as compared with that before treatment (11.0% +/- 7.5%, P < 0.01). The normal sperm ratio was increased after acupuncture (21.1% +/- 10.4% vs 16.2% +/- 8.2%, P < 0.05). The fertilization rates after acupuncture (66.2%) were obviously higher than that before treatment (40.2%, P < 0.01). There was no significant difference in sperm concentration and general sperm motility between before and after acupuncture. The embryo quality after acupuncture was improved, but the difference between them was not significant (P > 0.05). Acupuncture can improve sperm quality and fertilization rates in assisted reproductive technology.

J Huazhong Univ Sci Technolog Med Sci. 2002;22(3):228-30.

Effect of electro-acupuncture on ovarian expression of alpha (1)- and beta (2)-adrenoceptors, and p75 neurotrophin receptors in rats with steroid-induced polycystic ovaries.
Manni L, Lundeberg T, Holmang A, Aloe L, Stener-Victorin E.

Cardiovascular Institute and Wallenberg Laboratory, Sahlgrenska Academy, Goteborg University, SE-413 45 Goteborg, Sweden. l.manni@in.rm.cnr.it

BACKGROUND: Estradiol valerate (EV)-induced polycystic ovaries (PCO) in rats is associated with an increase in ovarian sympathetic outflow. Low-frequency (2 Hz) electro-acupuncture (EA) has been shown to modulate sympathetic markers as well as ovarian blood flow as a reflex response via the ovarian sympathetic nerves, in rats with EV-induced PCO. METHODS: In the present study, we further tested the hypothesis that repeated 2 Hz EA treatments modulate ovarian sympathetic outflow in rats with PCO, induced by a single i.m. injection of EV, by investigating the mRNA expression, the amount and distribution of proteins of alpha1a-, alpha1b-, alpha1d-, and beta2-adrenoceptors (ARs), as well as the low-affinity neurotrophin receptor (p75NTR). RESULTS: It was found that EV injection results in significantly higher mRNA expression of ovarian alpha1b- and alpha1d-AR in PCO rats compared to control rats. The p75NTR and beta2-ARs mRNA expression were unchanged in the PCO ovary. Low-frequency EA resulted in a significantly lower expression of beta2-ARs mRNA expression in PCO rats. The p75NTR mRNA was unaffected in both PCO and control rats. PCO ovaries displayed significantly higher amount of protein of alpha1a-, alpha1b- and alpha1d-ARs, and of p75NTR, compared to control rats, that were all counteracted by repeated low-frequency EA treatments, except for alpha1b-AR. CONCLUSION: The present study shows that EA normalizes most of the EV-induced changes in ovarian ARs. Furthermore, EA was able to prevent the EV-induced up regulation of p75NTR, probably by normalizing the sympathetic ovarian response to NGF action. Our data indicate a possible role of EA in the regulation of ovarian responsiveness to sympathetic inputs and depict a possible complementary therapeutic approach to overcoming sympathetic-related anovulation in women with PCOS.

Electro-acupuncture reverses nerve growth factor abundance in experimental polycystic ovaries in the rat.

Bai YH, Lim SC, Song CH, Bae CS, Jin CS, Choi BC, Jang CH, Lee SH, Pak SC.

Research Division of Biological Science, Chosun University Medical School, Gwangju, Korea.

Polycystic ovary syndrome (PCOS) remains one of the most common causes of anovulation in women of reproductive age. There is some evidence that nerve growth factor (NGF) is involved in the pathogenesis of PCOS. Therefore, seeking the pathogenesis of PCOS is important for controlling fertility. In traditional Oriental Medicine, acupuncture has been used for the function of ovaries. The present study was designed to determine whether electro-acupuncture (EA) could affect experimentally induced polycystic ovary (PCO) in the rat. The two acupoints Sp-6 and E-128 were stimulated to test for efficacy in the protein expression of NGF. Polycystic ovaries were induced by a single injection of estradiol valerate (4 mg i.m.). During the experimental period of 8 weeks, some of the rats were treated with EA twice weekly; this group was compared with a vehicle-treated control group and an estradiol-injected group not subjected to EA. At day 60, the protein expression of NGF was examined by immunohistochemistry in the ovaries, the adrenal glands and some parts of the brain. The estradiol treatment induced a clear PCO appearance, and was associated with a robust increase in NGF expression in the ovaries, the adrenal glands and the brain. EA treatment partly reversed the NGF abundance, particularly in the ovaries, but not in the brain. Our data show that EA affects the NGF involvement in ovarian dysfunction. Copyright 2004 S. Karger AG, Basel

Effects of electro-acupuncture on anovulation in women with polycystic ovary syndrome.
Stener-Victorin E, Waldenstrom U, Tagnfors U, Lundeberg T, Lindstedt G, Janson PO.

Department of Obstetrics and Gynecology, Goteborg University, Sweden.

BACKGROUND: The present study was designed to evaluate if electro-acupuncture (EA) could affect oligo-/anovulation and related endocrine and neuroendocrine parameters in women with polycystic ovary syndrome (PCOS). METHODS: Twenty-four women (between the ages of 24 and 40 years) with PCOS and oligo-/amenorrhea were included in this non-randomized, longitudinal, prospective study. The study period was defined as the period extending from 3 months before the first EA treatment, to 3 months after the last EA treatment (10-14 treatments), in total 8-9 months. The menstrual and ovulation patterns were confirmed by recording of vaginal bleedings and by daily registrations of the basal body temperature (BBT). Blood samples were collected within a week before the first EA, within a week after the last EA and 3 months after EA. RESULTS: Nine women (38%) experienced a good effect. They displayed a mean of 0.66 ovulations/woman and month in the period during and after the EA period compared to a mean of 0.15 before the EA period (p=0.004). Before EA, women with a good effect had a significantly lower body-mass index (BMI) (p<0.001), waist-to-hip circumference ratio (WHR) (p=0.0058), serum testosterone concentration (p=0.0098), serum testosterone/sex hormone binding globulin (SHBG) ratio (p=0.011) and serum basal insulin concentration (p=0.0054), and a significantly higher concentration of serum SHBG (p=0.040) than did those women with no effect. CONCLUSION: Repeated EA treatments induce regular ovulations in more than one third of the women with PCOS. The group of women with good effect had a less androgenic hormonal profile before treatment and a less pronounced metabolic disturbance compared with the group with no effect. For this selected group EA offers an alternative to pharmacological ovulation induction.

Acupuncture normalizes dysfunction of hypothalamic-pituitary-ovarian axis.

Chen BY.

Institute of Acupuncture, Shanghai Medical University, P.R. China.

This article summarizes the studies of the mechanism of electroacupuncture (EA) in the regulation of the abnormal function of hypothalamic-pituitary-ovarian axis (HPOA) in our laboratory. Clinical observation showed that EA with the effective acupoints could cure some anovulatory patients in a highly effective rate and the experimental results suggested that EA might regulate the dysfunction of HPOA in several ways, which means EA could influence some gene expression of brain, thereby, normalizing secretion of some hormones, such as GnRH, LH and E2. The effects of EA might possess a relative specificity on acupoints.

Acupunct Electrother Res. 1997;22(2):97-108.