There is a growing amount of research that supports the notion that acupuncture used in conjunction with in-vitro fertilization may increase the outcome of pregnancy. Randomized, controlled, double-blind studies are the current gold standard for research trials, and as you might imagine, they are difficult to produce with something like acupuncture. The RCT standard was developed to test pharmaceutical medications, where placebo pills could easily be swapped for actual pharmaceuticals without either the patient or the physician knowing. With acupuncture, we have to get more creative.
There are standards being used that come close to the gold standard (but each have a few problems of their own). One method utilizes the technique called sham acupuncture, whereby guide tubes and a sharp plastic implement poke the actual points, but do not break the skin. The patient presumably does not know whether they are receiving true acupuncture (with needle retention) or simply a simulated acupuncture sensation at the point. This method is a good idea, but a problem arises in that acupressure is sometimes a very effective modality. How many times has your acupuncturist placed seeds on your ear to stimulate points? Still, it comes close to following the gold standard of research and allows acupuncture to move into the research realm with increasing amounts of evidence. Another form of sham acupuncture involves acupuncture needles being inserted into the body at points different from the 360 mapped acupuncture points along the meridians. This would also be a great idea if it weren’t for “ashi” points, which we can think of like trigger points. These areas of great tenderness often refer to another part of the body and when needled, cause tension patterns to release. There are many points utilized in acupuncture that are not on the mapped meridians, but are quite effective in alleviating tension and improving circulation.
Another way we attempt to adhere to the gold standard for research within the acupuncture realm is by blinding the acupuncturist. This usually means having someone who is not trained in acupuncture administer the technique. Often a physician in these research scenes, they are more than qualified to follow instructions, but they are not trained in the art of acupuncture. It is not simply the placing of a needle, but the manipulation of the needle to achieve a desired effect. How often has your acupuncturist placed a needle that you didn’t feel until they began to move it in a certain way, eliciting a strong sensation sometimes felt in another area of your body?
Regardless of the problems that acupuncture researchers have had with attempting to produce quality research within a standard not intended for a customizable medicine, acupuncture and infertility have made big headway. So much headway, in fact, that an accepted protocol has arisen and is well-known in the specific realm of In-Vitro Fertilization. Repeated studies have produced similar results: doing acupuncture before and after receiving IVF increases the likelihood of pregnancy. As more Ob-Gyn physicians talk to their patients about acupuncture, we receive more inquires about acupuncture and fertility.
Yes, all three of our practitioners at Thompson Family Acupuncture are familiar with the research and can administer the specific protocol before and after IVF to increase likelihood of pregnancy. As practitioners of Chinese Medicine, we also want to have a little time to bolster the woman’s constitution and address the reason why miscarriages may be happening. With my fertility patients, I specifically request 3-6 months of actively avoiding pregnancy while being treated with Chinese Medicine. It’s important, especially when there have been multiple miscarriages, to give the body a chance to fully recover. Herbs are very important at this stage and provide the essential building blocks to deeply nourish the quality of blood and the womb. Sometimes a woman is unable to provide time, and it is here that acupuncture becomes the primary modality for assisting her body in a healthy, full-term pregnancy.
In the best case scenario for promoting fertility, we treat both the man and the woman for 3-6 months utilizing herbs and acupuncture prior to active attempts at pregnancy. From a Chinese Medicine point of view, it is just as important to nourish the blood and jing in the man as it is in the woman. By nourishing and supporting both parties, we increase the likelihood of full-term pregnancy and a healthy baby. Although you will not find many RCT studies that take into account the individual, understanding a bit about acupuncture and research might begin to explain why. We do our best to fit into the Western paradigm of research trials, and have gained much credibility amongst Western physicians by doing so. Yet, at the heart of it, Chinese Medicine always treats the individual. In the case of fertility, treating the two individuals is ideal.