Click
Here
for more articles |
|
|
Traditional
Chinese Medicine and Infertility - Part
II |
by:
Dr.
Mike Berkley |
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 |
|
