The definition of infertility is usually the failure to conceive after 1 year of unprotected intercourse (European Society 1996). Infertility can be primary, in women who have never conceived, or secondary, in women who have previously conceived. Overall, there are about 10–20% of infertility cases are unexplained (Isaksson 2004). The rest is the result of ovulatory failure (27%), tubal damage (14%), endometriosis (5%), low sperm count or quality (19%), or other causes (5%) (Effective Health Care 1992).
In developed countries, 95% of couples attempting to conceive are successful after 2 years (Brosens 2004). However, the chances of becoming pregnant vary with the cause and duration of infertility, the woman’s age, the woman’s previous pregnancy history, and the availability of different treatment options (Templeton 1998, Collins 1995). For the first 2–3 years of unexplained infertility, cumulative conception rates are 27-46% but decrease with increasing age of the woman and duration of infertility (Collins 1995).
The aims of infertility treatment in conventional medicine are to achieve the delivery of one healthy baby and to reduce the distress associated with infertility, with minimal adverse effects. Interventions include intrauterine insemination plus controlled ovarian stimulation, in vitro fertilization, intracytoplasmic sperm injection, gonadotrophin releasing hormone agonists, clomifene and tamoxifen, laparoscopic ovarian drilling, tubal flushing, and laparoscopic ablation of endometrial deposits, depending on the cause of the infertility (Al-Inany 2004).
Researches show acupuncture may help in the treatment of infertility by:
- regulating fertility hormones – stress and other factors can disrupt the function of the hypothalamic pituitary-ovarian axis (HPOA). Acupuncture promotes the release of beta-endorphin in the brain, which regulates gonadatrophin releasing hormone from the hypothalamus, follicle stimulating hormone from the pituitary gland, and oestrogen and progesterone levels from the ovary (Anderson 2007).
- increasing blood flow to the reproductive organs (Ho 2009, Anderson 2007), which can improve the thickness of the endometrial lining, so increasing the chances of embryo implantation.
- increasing egg production (Jin 2009) and improving oocyte quality (Chen 2009), which could increase the chance of fertilization.
- enhancing luteal function (Huang 2009)
- regulating follicle stimulation hormone-receptor expression (Jin 2009).
- normalizing cortisol and prolactin levels on IVF medication days (Magarelli 2008); reducing stress (Anderson 2007)
- promoting embryo implantation (Liu 2008).
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