Monday, February 18, 2008

Acupuncture for Conception

This ABC News article is something I've heard many women talk about. Most of them already have one baby, but are having trouble getting pregnant a second or third time. This article looks at adding acupuncture to in vitro fertilization procedures, but I know people who have just tried acupuncture by itself to get pregnant. After the article, there is an interview I did with an acupuncturist.

It sounds far-fetched -- sticking needles in women to help them become pregnant -- but a scientific review suggests that acupuncture might improve the odds of conceiving if done right before or after embryos are placed in the womb.

A pregnant Dr. Ann Trevino had trouble getting pregnant with intrauterine insemination before trying acupuncture.

The surprising finding is far from proven, and there are only theories for how and why acupuncture might work. However, some fertility specialists say they are hopeful that this relatively inexpensive and simple treatment might ultimately prove to be a useful add-on to traditional methods.

"It is being taken more seriously across our specialty," and more doctors are training in it, said Dr. William Gibbons, who runs a fertility clinic in Baton Rouge, Louisiana, and is past president of the Society for Assisted Reproductive Technology.

"I have not seen proof ... but we wouldn't mind at all" if it turned out to work, he said.

The analysis was led by Eric Manheimer, a researcher at the University of Maryland School of Medicine, and paid for by a federal agency, the National Center for Complementary and Alternative Medicine. Results were published Friday in the British medical journal, BMJ.

Acupuncture involves placing very thin needles at specific points on the body to try to control pain and reduce stress. In fertility treatment, it is thought to increase blood flow to the uterus, relax the cervix and inhibit "fight or flight" stress hormones that can make it tougher for an embryo to implant, Manheimer said.

The analysis pools results from seven studies on 1,366 women in the United States, Germany, Australia and Denmark who are having in vitro fertilization, or IVF. It involves mixing sperm and eggs in a lab dish to create embryos that are placed in the womb.

Women were randomly assigned to receive IVF alone, IVF with acupuncture within a day of embryo transfer, or IVF plus sham acupuncture, in which needles were placed too shallowly or in spots not thought to matter.

Individually, only three of the studies found acupuncture beneficial, three found a trend toward benefit and one found no benefit. When results of these smaller studies were pooled, researchers found that the odds of conceiving went up about 65 percent for women given acupuncture.

Experts warn against focusing on that number, because this type of analysis with pooled results is not proof that acupuncture helps at all, let alone by how much. IVF results in pregnancy about 35 percent of the time. Adding acupuncture might boost that to around 45 percent, the researchers said.

The authors include doctors from the Netherlands and Georgetown University in Washington, D.C. One is an acupuncturist but had no role in any studies that were analyzed.

The American Society for Reproductive Medicine has no policy on acupuncture. "There's been a lot of conflicting research" on its usefulness, said spokeswoman Eleanor Nicoll.

"It looks like, from the body of evidence out there, that some patients benefit," said Dr. James Grifo, head of the infertility program at New York University.

However, Dr. Zev Rosenwaks, director of infertility treatment at New York-Presbyterian Hospital/Weill Cornell Medical Center, said other studies, reported at recent medical meetings and not included in the published analysis, did not find it helped.

"The jury is still out," he said, but added, "It's unlikely that acupuncture does any harm."

Dr. Ann Trevino, a 37-year-old family physician who recently moved to Houston, is pregnant, and a believer. She had three unsuccessful pregnancy attempts with intrauterine insemination before trying acupuncture with IVF at a fertility clinic in San Antonio where she used to live.

"I had been reading about acupuncture, probably like every other patient on the Internet. I was just willing to do anything possible to improve our chances," she said. With acupuncture, "I just felt very warm and relaxed" when the embryos were placed.

Dr. Francisco Arredondo, who runs Reproductive Medicine Associates of Texas where Trevino was treated, said he started offering acupuncture in October, after patients requested it and because some studies suggested it helped.

Acupuncturist Kirsten Karchmer said she places about a dozen needles in the ears, hands, feet, lower legs, abdomen and sometimes the lower back. It costs $500 a month for treatments twice a week, and patients typically go for three months, she said.

IVF costs around $12,000 per attempt, so a treatment that improves its effectiveness might save money in the long run, Manheimer said.

I called Dr. Keith Kramer from Kramer Chiropractic and Acupuncture Center in Peoria, IL to get his take on this article. He said he does offer acupuncture for infertility. He sees women at all stages of infertility, but he most often treats women who have had several failed in vitro attempts. Infertility Specialists at the Sheer Institute in Peoria, IL often refer patients to Dr. Kramer. He has been acupuncture for conception for that last 7-8 years.

My first question was how does acupuncture help women get pregnant? Dr. Kramer said there are several points on the human body that increase fertility in women AND in men. He said acupuncture works by balancing the person's energy system "to make sure you are functioning the best you can, taking the stress off your body." Dr. Kramer said, "I'm sure you've heard stories before when people try and try to get pregnant and as soon as they give up, they get pregnant. Sometimes the planning stresses people out too much."

If a woman is trying to get pregnant, Dr. Kramer has her come in once a week for a half hour session. If the woman has had a miscarriage, he usually continues the sessions until the woman is 20 weeks pregnant. If the woman is undergoing in vitro fertilization, he has her come in twice a week until conception, then once a week until 20 weeks. Dr. Kramer said, "I have just had success with that. I don't like cutting them loose as soon as they get pregnant. I like to make sure they're as healthy as possible and make sure their energy is balanced through the 20 week point, just to support the body."

The Cost is $65 for a half hour session. Acupuncture is not covered by all insurance companies. Dr. Kramer said it's about 50/50. Caterpillar does cover it.

I asked him what he tells skeptics. Kramer responded, "Skeptics, of course. Half the treatment option is having an open mind. Nothing is 100 percent. My success rate is 50-60 percent. I'm getting the tough ones. I'm getting the ones with adhesions around their fallopian tubes and cysts."

Kramer said acupuncture does not hurt. The needles are very tiny, about the diameter of a hair shaft. Acupuncture for conception is performed on a woman's stomach, a man and woman's lower back and sometimes around the ankles.

I know there are a whole slew of people who think acupuncture is a waste of money. Personally, I have no idea whether the treatment is beneficial, but it is interesting. So, I thought I would pass on the information to you so you can make your own decision.

-NewsAnchorMom Jen


Peoria Pundit said...

Acupuncture is just as fake as chiropractic. Sorry. I rather wear magnets in my shoes, as it's less invasive and works about as well. said...

Now Pundit,
Have you tried acupuncture? I haven't.I am just wondering what people who have tried it think about its effectiveness. said...

I found your blog post through a google search and just wanted to weigh in... I have severe Rheumatoid Arthritis and have been on heavy chemotherapy and other medicines for a few years (and I'm only 26 years old). In order to start trying to get pregnant, you have to be off of meds for 3 to 4 months - which is often impossible as the pain is excruciating. At the advice of my doctor and colleagues (I work for a pharma company and even they find value in eastern medicine), I started acupunture.
I was quite sceptical, but have realized that it certainly helps. First, I've had 75% less pain due to the arthritis due to the acupuncture sessions. Since eastern medicine aims at balancing out your body (as opposed to western medicine targeting one problem or area), it has helped in many ways. I understand that it is difficult to accept as it does not have scientific studies behind it, but it has been used in the east for hundreds of years and is still being used over western medicine in some cases.
As for the fertility, the jury is still out for a few months for me, but I can tell you that it's made the process much more comfortable and has increased my well being.

I have to stick with the good 'ole "dont knock it unless you've tried it" on this one... even if the packaging of the treatment is a little different than what we're used to, given the number of people (patients, medical professionals, etc) that it helps, I wouldn't discount it as being fake.

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