By Anna Pyne, L.Ac.A TCM

Polycystic ovarian syndrome (PCOS) is a common reproductive endocrine disorder and something we frequently treat at Pulling Down the Moon. Up to 75% of women with this diagnosis do not ovulate, which is hardly ideal when trying to conceive.   In fact, it’s not until they have trouble conceiving that many women learn they have PCOS, which in addition to causing infertility can also have negative long-term health consequences including heart disease and diabetes.

In Traditional Chinese Medicine, PCOS is considered an anovulation disorder related to ovarian insulin resistance.*  Chinese medicine initially acknowledged PCOS in the 1200’s describing it as a “Tian Gui” disorder, meaning a genetic disorder with the main symptoms being cycle irregularity and infertility due to anovulation.  There are a number of TCM patterns of diagnosis to describe PCOS, the main one being a (Chinese) Kidney Deficiency. The kidney in TCM is the organ system that is regarded with any genetic disorder and considered the root cause in PCOS.  The absence of the period, and therefore the absence of ovulation is a kidney pathology.  Interestingly, modern science has just recently identified a genetic component to PCOS and now think of PCOS as a hereditary problem in which symptoms often do not present until later in life.

A secondary pattern in TCM is Spleen Deficiency, which has to do with the insulin resistance part of the PCOS diagnosis. The Chinese spleen is responsible for the metabolism of nutrients from foods, as well as the transformation and transportation of fluids in the body. In patients with actual cysts in the ovaries, TCM considers the spleen to be dysfunctional. This is also the organ that relates to weight gain. Obesity is seen in 30%-60% of patients with PCOS. By improving the function of the spleen we help regulate blood sugar and resolve the excess fluid accumulation from ovarian cysts and/or fat from weight gain.  A third, related TCM pattern is Liver Stagnation, which can manifest as blood stasis or excess heat in the channels. Blood Stasis in the channels causes hair follicles to be nourished excessively creating coarse unwanted hair. This represents the hirsutism symptom, of which 70% of patients with PCOS have. Excess heat in the channels also promotes the acne component of PCOS.

When trying to improve fertility in patients with PCOS the primary focus is to induce ovulation.  According to TCM pattern diagnosis, the main organs treated for this condition are the kidney, spleen, and liver.  Treatment using TCM pattern diagnosis is greatly successful in inducing ovulation and a skilled TCM practitioner can use a combination of acupuncture, electro-acupuncture, moxabustion and herbal therapy to treat Polycystic Ovarian Syndrome. 

*Different phenotypes of polycystic ovary syndrome by Rotterdam criteria are differently steroidogenic but similarly insulin resistant. Fertil Steril. 2010 Mar 1;93(4):1362-5. Epub 2009 Sep 26.

Book an initial consultation with Anna Pyne in Chicago here.

  A Fertility Acupuncture Primer by Pamela Policastro L.Ac.

Even though it may seem like a new trend to the modern fertility patient, the use of the Chinese healing art of acupuncture to treat fertility is one that can be dated back at least two thousand years.   A lot of my patients are curious about the “tools of the trade,” because like a modern doctor, I do use an array of therapeutic instruments to treat my patients.  The tools I use to help restore my patient’s fertility may not require as much electricity as an RE’s, but since they have been passed down and perfected over a couple thousand years, I would definitey argue that they are pretty state-of-the-art. 

You may have heard that one of the most important concepts of Chinese medicine for fertility (or any other illness/symptom) is that of natural balance.  When proper balance of energy exists, the body has acheived  a healthy circulation of qi, or life force.  Qi flows throughout the body along channels called “meridians”.  When the flow of qi is insufficient, unbalanced, or interrupted, illness may occur.  Acupuncture is the insertion of very fine needles (sometimes in combination with electrical stimulus or with heat produced by burning specific herbs called Moxibustion – more about  this later)  into the skin at specific acupuncture points in order to influence the functioning of the body.  The choice of acupuncture points varies from patient to patient and treatment to treatment and relies on very careful diagnosis of different kinds (another topic!).

Let us first discuss the acupuncture needle.  The earliest primitive acupuncture instrument used in ancient China was the “stone needle” (ouch!).  This eventually developed into what is called “the nine needles” made of metal.  The nine needles were used for various depths of entry into the body and were of different shapes and sizes:  sharpened, round, elongated and miniature.  With the advance of manufacturing technology, acupuncture needles are being made with greater and greater precision.  Modern acupuncure needles are about the thickness of a hair brush wire and are designed to be virtually painless upon insertion.  The needles modern TCM practitioners use are single-use and sterile.

Today, like the acupuncturists of two thousand years ago, the acupuncture needle is used by the practitioner to unblock energy flow in order to restore health or reduce pain.  For example, the acupuncturist can move stagnation to relieve painful pms symptoms.  The needles are also used for supplementing various deficiencies; to treat a woman who has missed a period due to blood deficiency, for example.  Lastly, the needles can also be used to drain an excess which is creating imbalance as in the case of a woman who experiences extra-long periods and may have excess heat in the blood.

So now you know a bit more about acupuncture and needles.  Stay tuned for the next chapter of  “Tools of the TCM Trade.”  Please feel free to comment with any questions you may have about acupuncture and the treatment of infertility. 

To book an initial fertility acupuncture consultation with Pamela at our Arlington Heights office, click here.

By Anna Pyne LAc MSOM

You may have read my recent post about an Ann Arbor study* that found electro-acupuncture, in conjunction with Traditional Chinese Medicine pattern diagnosis, achieved IVF success rates double that of the national average.   Because the results of this study are so striking, we wanted to take a closer look. 

What makes this study interesting is that it adheres to a main tenet of Traditional Chinese Medicine – that treatment is individualized according to a patient’s specific diagnosis, rather than a standardized protocol.  In this study, acupuncture points, chosen according to a patient’s traditional Chinese medicine pattern, were combined with electro-acupuncture and the researchers found the likelihood of a conception was greatly improved.  

The study compared three different groups of acupuncture patients all going through a typical medicated IVF cycle.  The first group was a traditional Chinese acupuncture (TCA) group, which used selective points based on the individual’s presenting pattern.   There were five different Chinese medical diagnostic patterns recognized and three to five points were selected for treatment based on each patient’s specific pattern.   The second group used electro-acupuncture (EA) based off of points used in a previous Swedish study done by Stener-Victorin et al which was published in Human Reproduction**.  The third group used a combination of both TCA and EA. Acupuncture intervention for all groups consisted of a minimum of 12 treatments, two per week, prior to embryo transfer.  

The frequency of treatment in this study is higher than many other studies (including the Sterner-Victorin study which used 8 sessions)  looking at acupuncture and IVF.  Patients had a minimum of 12 sessions (2 per week) prior to transfer and about half of the patients had more than 13 treatments.   All groups had IVF conception rates higher than the national average, but it was the third group that had the best outcome with an 81% success rate. The first group (TCA only) had a 64% success rate and the second group (EA only) had a 63% success rate.

Now, in case you’re a bit freaked out by the term “electro-acupuncture,”  I’d like to take a moment to dispel your fears.  Electro-acupuncture is a technique where a TENS (transcutaneous electrical nerve stimulation) machine is attached with small clips directly to acupuncture needles. When electricity is applied to the needles, the sensation is that of a light tapping.  Some patients have even asked me if I’m tapping them with my finger when I’ve used EA on them, but I’m not, that’s simply the sensation caused by the TENS machine.  It’s a comfortable feeling that is kept constant during the entire treatment session. By stimulating the points we are further enhancing their function, thereby intensifying the effect of treatment.

These results from the Ann Arbor study show the importance of using a differential traditional Chinese medicine diagnosis with the benefit of the added stimulation from the electro-acupuncture. I have seen this to be true empirically in my fertility practice so when this study came out it was especially exciting to see that it affirms my practical experience.

Please feel free post your comments and questions! 

http://www.liebertonline.com/doi/pdfplus/10.1089/acu.2009.0692* http://humrep.oxfordjournals.org/cgi/content/abstract/11/6/1314**

By Anna Pyne LAc MSOM

A recent study entitled “Acupuncture as an Adjunct to In Vitro Fertilization: A Randomized Trial” was published in the journal Medical Acupuncture showing that electro-acupuncture used in conjunction with Traditional Chinese Acupuncture doubled the pregnancy success rates of IVF patients as compared to the national average of patients undergoing IVF.*    The study was conducted at Acupuncture and Chinese Medical Center in Ann Arbor Michigan using a total of 52 IVF patients with the average age of 38 years.  The patients in the study were randomly divided into three different groups:  1) traditional Chinese acupuncture (TCA) plus electro-acupuncture (EA), 2) TCA-only, or 3) EA-only.   All patients also underwent “standard IVF medication regimen.”   The authors of this study did not include an IVF-only control group and compared their treatment outcomes to average U.S. IVF success rates. 

According to the Center for Disease Control and Prevention the average success rate of IVF alone is about 40%.  In this study all groups had higher IVF success rates than the average U.S. success rate, and the improvement was greatest when TCA and EA were used in conjunction.  The authors conclude a “marked increase with the combination of TCA and EA (81.8% success rate)”!*  The TCA alone group had a 64% success rate, and the EA alone group had a 63% success rate.  The points used in the TCA and EA group were determined based upon the patient’s individual traditional Chinese medical diagnosis.  This study proves that traditional Chinese acupuncture in combination with electro-acupuncture “…is a promising new technique for the treatment of infertility with a higher IVF success rate than that of TCA or EA alone.”*   

While this study would have been strengthened by the addition of an IVF-only control group, the findings of this study are supportive of the growing body of evidence that treatment with Traditional Chinese Acupuncture does increase a woman’s chances of conception with IVF. 

*Medical Acupuncture Volume 21, Number 3, 2009 “Acupuncture as An Adjunct to In Vitro Fertilization: A Randomized Trial”