Acupuncture Treatment for Fertility.

Infertility is considered as the inability to conceive in a sexually active couple who are trying to get pregnant for one year. 8-12% of the couples in the world are facing problems with infertility, and in these modern times, the per cent is getting bigger. 20% of the cases are due to both male, and female factor [ 1 ] [ 2 ] Problems that are possible to arise in men are abnormal sperm, low sperm motility or low sperm count. Causes can be genetic factors, long-term use of steroids, age, obesity, stress, and inflammation of the testicles, cystic fibrosis, diabetes and other diseases. In women problems that can arise are a polycystic ovarian syndrome, hyperprolactinemia, thyroid problems, hormonal imbalance, poor egg quality, cancer, AIDS, etc. Risk factors and causes are age, obesity, eating disorders, smoking, alcohol, stress, infections and other [ 1 ]. By the theory of Traditional Chinese Medicine (TCM) infertility occurs due to disrupted vital balance and blockages in the Qi energy and Blood circulation flow. When the free flow of the energy is blocked, it can cause deficiency, stagnancy or heat syndrome [ 3 ]. Deficiency syndrome is blocking and disrupting the sexual and reproductive function both in men and women. The stagnancy syndrome disables the free flow of the energy and Blood and restricts it from circulation to the tissues in the reproductive organs. The heat syndrome is connected to inflammation processes which have an impact on semen quality and gynaecological infections. All three syndromes can be treated with Traditional Chinese Medicine, concretely with acupuncture and herbs [ 4 ] [ 5 ]. When it is known which syndrome to treat, and the problem is solved, the body returns to health and conception may happen naturally. TCM sees every patient as unique, and the treatment is made by their current condition and constitution. With such a long history for more than 5000 years, TCM is highly effective with no side effects. Acupuncture as part of the TCM as a treatment for infertility is used for a very long time. With the insertion of tiny sterile needles into acupoints located at specific points on the body the way the body functions can be regulated and the problem that affects fertility can be addressed. Acupuncture treatment can balance the hormones, strengthen the immune system, regulate the energy and Blood flow, remove the stasis and phlegm and stimulate the nervous system. With a combination of acupuncture and herbs, it is possible to improve the ovarian and follicular function and increase the blood flow to the endometrium [ 3 ] [ 6 ] [ 7 ].

When treating infertility both male and female factor is very important. Therefore both patients have done the treatment at the same time. On both patients were used the same points. The male patient has done 4 treatments to improve the sperm quality. Before the treatment, the patient has done one sperm test. Results from the test show a small amount of progressively moving sperm cells (5%) and a limited amount of immobile sperm cells (50%). The results from the sperm test done before the treatment are shown in Table 1 . Results from the sperm test analysis The female patient had ovarian endometriotic cysts or ‘chocolate’ cysts on both ovaries. After 7 treatments the cysts were gone, and the patient got pregnant spontaneously successfully. Figure 1 , is shown ultrasound image done before the treatment showing the cysts on both ovaries. Ultrasound image report before the treatment Figure 2 is shown ultrasound image done after the treatment showing the cysts are gone from both ovaries. Ultrasound image report after the treatment Table 2 are shown the results from the blood test analysis done after the treatment. Results are showing normal hormone levels of Prolactin, Estradiol, TSH, LH, FSH and Testosterone, low tumour markers levels (CEA, OMMA, GIMA) and increased HCG hormone level indicating that the patient is pregnant in a second/third gestational week. Blood test results

The points used in the treatment were chosen with the aim to help the patients to improve the energy flow to the reproductive organs, warm the Blood for better circulation and remove the blockages that cause stagnation in the flow. Ovarian cysts can occur because of stagnation in the Liver Qi, caused by excessive dampness. Excessive dampness is caused by blood stasis and fluids accumulated in the abdomen which slowly becomes phlegm. Accumulation of phlegm and fluids in the lower body is a problem of the Kidney Yang, i.e. a failure of the Kidney to send the water upward. When the water stays in the lower body, then it transforms into phlegm. Therefore the Kidney fails to support the Liver. The main function of the Liver and Kidney meridians is to remove the toxins from the body. If this function is weakened, then the immune system can be disturbed, and abnormal immune reactions may be triggered by the growth of abnormal tissue in the female reproductive organs. In TCM, if there is no good and free blood circulation in the body, blood stagnation can occur and lead to disease [ 3 ] [ 5 ] [ 6 ] [ 8 ] [ 9 ]. When the cysts are formed because of accumulated water and fluids, the three principal methods of treatments are: (1) yo warm the Kidney with the aim to prevent further accumulation; (2) resolve the phlegm masses, and (3) restore normal blood circulation to the affected area [ 5 ]. In TCM, infertility in male patients is also a problem of Liver Qi stagnation, Kidney deficiency and accumulation of dampness and heat in the lower abdomen. Therefore the treatment protocol is the same in both patients [ 10 ] [ 11 ]. The treatment in both patients aims to remove the liver toxins, dissolve blood stagnations in the liver, nourish the Kidney Qi, invigorate the Blood, lower stress and stimulate the whole body to function better [ 3 ] [ 11 ]. In conclusion, acupuncture as a treatment for infertility shows great results both in man and women. Acupuncture can be considered as successful treatment in restoring fertility in the patients, by improving the sperm quality and ovaries function and balancing the endocrine system and hormones.

In this research is presented a case of a young couple, 28 years old man and woman who were unable to conceive after trying for a year. The male patient is with normal findings, normal blood pressure, blood sugar and appetite. Before starting the treatments, the patient was taking E vitamin and Tribestan tablets for improving fertility and to stimulate testosterone excretion. The acupuncture treatment was made to improve the sperm quality. The female patient is diagnosed with endometriosis on both ovaries. On the scans done before the treatment are visible ‘chocolate’ cysts on both ovaries. Since the patient was diagnosed, she was taking hormonal therapy for one year and one month before starting the acupuncture treatment the hormonal therapy was stopped. The menstrual cycle is regular but very painful. The patient was also struggling with hormonal acne on the face. Both of the patients were treated with acupuncture treatment in a clinic for TCM and acupuncture in Skopje, Macedonia by a doctor specialist in acupuncture. Treatments were with duration of 35-40 minutes on both sides of the body. Treatments were done indoors, at room temperature, once a week in three months. In the treatment were used fine sterile disposable needles 0.25 x 25mm manufactured by Wuijuiang City Medical & Health Material Co., LTD. Points that were used in the treatment in both patients are: HN1 (SiShenCong), LI4 (HeGu), ST36 (ZuSanLi), GB34 (YangLingQuan), SP9 (YinLingQuan), SP6 (SanYinJiao), LR3 (TaiChong), RN13 (ZhongWan), RN7 (QiHai), RN4 (GuanYuan), RN2 (QuGu), ST29 (GuiLai), ST25 (TianShu), GB20 (FengChi), DU14 (DaZhui), BL18 (GanShu), BL19 (DanShu), BL20 (PiShu), BL21 (WeiShu), BL25 DaChangShu) and BL32 (CiLiao).