Overview
Diminished ovarian reserve is a primary cause of infertility in older women. This problem has increased as more women put off starting a family while pursuing a career. Improving ovarian function is essential to increase pregnancy rates in women undergoing fertility treatment. Unfortunately, western medicine has no effective drugs to restore ovarian function in women. However, acupuncture improves ovarian function safely and effectively. This paper investigates acupuncture’s mechanism, clinical efficacy, and future application prospects in improving ovarian function in women.
Diminished Ovarian Reserve
Women starting families later in life often have diminished ovarian reserve, leading to female infertility. This condition manifests as a decreased number and quality of follicles. Research indicates that reduced ovarian reserve (DOR) incidence has been increasing yearly, trending toward younger onset. Women with diminished ovarian reserve often suffer from irregular menstruation or amenorrhea (no period), infertility, menopausal symptoms, anxiety, and depression.
Hormone Replacement Therapy Versus Acupuncture
Western doctors currently use hormone replacement therapy (HRT) to treat female diminished ovarian reserve to mimic regular hormonal changes. In contrast, acupuncture has fewer adverse effects in clinical applications and has gained worldwide attention for its efficacy in treating infertility. In addition, many studies have shown that acupuncture positively regulates menstruation, resolves reproductive hormone imbalances, and improves follicular quality.
This paper discusses acupuncture’s mechanism, clinical efficacy, safety, and application prospects in treating diminished ovarian reserve and presents evidence that acupuncture improves ovarian function and increases ovarian reserve.
Acupuncture and Diminished Ovarian Reserve
Regulation of the female hypothalamic-pituitary-ovarian axis (HPO) and sex hormone levels is essential when treating infertility. The female HPO axis is the basis of female reproductive endocrine homeostasis, and the balance of reproductive hormones is closely related to ovarian function.
Acupuncture transmits impulses to the hypothalamus impacting the endocrine system and producing regulatory effects through the female HPO axis. Research has found through animal experiments that acupuncture effectively regulates the HPO axis, restoring the reproductive endocrine system to normal. In another study, acupuncture increased hypothalamic inhibitory neurotransmitters while decreasing excitatory neurotransmitters, which lowered FSH levels to improve reproductive hormone levels.
Additional Research on Ovarian Function
In addition, women with reduced ovarian function have lower estrogen and progesterone and higher FSH than healthy women of the same age. Research shows that acupuncture improves sex hormone levels and restores ovarian function by regulating the HPO axis. A recent study observed the effects of acupuncture on the HPO axis in non-ovulating rats at “Guan Yuan” and “San Yin Jiao” points. The results showed that acupuncture increased estrogen and reduced hypogonadotropic hormones, thereby normalizing reproductive hormones by regulating the HPO axis.
Another study observed the effect of electro-acupuncture on perimenopausal rats. Compared with the control group, the estradiol level in the electro-acupuncture group was significantly higher, while FSH, LH, and GnRH levels all decreased. Finally, a study assessing hormone replacement therapy (HRT) evaluated the efficacy of acupuncture on diminished ovarian reserve, finding that acupuncture reduced FSH and LH levels more dramatically compared to HRT. This result demonstrates that acupuncture is an effective treatment for patients with poor HRT results, unsuitable for HRT therapy, or who prefer non-pharmacological therapies.
Acupuncture Improves Ovarian Tissue
An animal study evaluating rats with ovarian atrophy also concluded that acupuncture improves ovarian function. The group treated with acupuncture showed larger sinus follicles, more cell layers than the control group, better luteal development, fewer atretic follicles, and less inflammatory infiltration. In addition, acupuncture increases mRNA expression in ovarian tissue to improve ovarian function. Oxidative reactions in the body trigger changes in the permeability of the mitochondrial membrane, resulting in the release of cytochrome C which results in cell death.
In contrast, acupuncture upregulates FSH and E2 levels to improve ovarian function. In addition, acupuncture improves the number of healthy ovarian follicles while reducing dysfunctional ones. Additional research found that acupuncture improved the blood supply to the ovaries through the sympathetic nerves, regulating the local microenvironment of the ovaries for better follicle development and maturation.
Acupuncture Treatment for Improving Ovarian Reserve
Milli-Needle Acupuncture
As the most traditional and straightforward method of acupuncture therapy, milli-needle acupuncture is the most widely used in clinical applications and requires only a few milli-needles to complete the treatment. A study by Shang J et al. showed that compared with the pre-needling period, FSH and LH decreased, and E2 and AMH increased in patients after treatment. This result indicates that acupuncture improves ovarian function by regulating reproductive endocrine levels.
The present analysis found that patients with sporadic menstruation due to ovarian hypofunction showed a more significant improvement in pregnancy rate after acupuncture treatment than those with amenorrhea. This result suggests that acupuncture can improve menstrual infertility due to ovarian hypofunction. Furthermore, a prospective study by Wang F et al. also confirmed that acupuncture significantly increased serum E2 levels in patients with ovarian hypofunction.
Electro-Acupuncture
Electro-acupuncture is a treatment method combining milli-needles and electrical stimulation to enhance the effect of milli-needle acupuncture. It improves the therapeutic effect of milli-needle acupuncture and expands the scope of treatment, which is now widely used in the clinic. Li R et al. showed that low-frequency electrical stimulation intervention (electrical frequency at 2 Hz) for 1 to 3 months in patients with diminished ovarian reserve before IVF could improve ovarian blood supply while lowering the patient’s blood FSH and LH levels.
Summary and Outlook
Acupuncture is an effective treatment for diminished ovarian reserve. In addition, current clinical evidence suggests that acupuncture restores the reproductive endocrine axis homeostasis in women, leading to improved FSH and E2 levels.
Acupuncture induces nerve conduction to regulate the female hypothalamic-pituitary-ovarian axis in both directions, bringing the secretion of female reproductive hormones into balance to normalize ovarian function. At the same time, acupuncture improves the blood supply to the ovaries and maintains the local microenvironmental homeostasis of the ovaries. The root cause of ovarian dysfunction is oxidative stress, which mediates the inflammatory response.
Acupuncture stimulates the expression of anti-inflammatory genes in ovarian cells to reduce damage to ovarian tissue. As a result, IVF acupuncture increases the number of eggs, quality follicles, and quality embryos and improves the clinical pregnancy rate. This all indicates the value of acupuncture in patients with diminished ovarian reserve. Furthermore, as a non-pharmacological treatment, acupuncture has fewer adverse effects than drugs and is quicker and easier to use than surgical methods.
Ovarian Function Conclusions
In conclusion, acupuncture improves ovarian function and is an appropriate therapy for female patients struggling with diminished ovarian reserve.
Next Steps
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Reference
Xu J, Fan Y, Geng J, Zhang Y, Xia T (2021) The Use of Acupuncture as an Alternative Treatment Method for Ovarian Dysfunction: A Narrative Review. J Clin Case Stu 6(3): dx.doi.org/10.16966/2471-4925.228
Focus keyphrase: Acupuncture Improves Ovarian Function
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I was scheduled for IVF and they suggested I get acupuncture beforehand to increase my chances of success. I went to Raleigh Acupuncture for a month before the procedure. It was very relaxing and definitely reduced my stress levels. My uterine lining also increased more than ever before. The IVF was a success and I’m now pregnant. It was definitely worth doing the acupuncture. I did not want to have to repeat IVF for $25K a pop. And when I got morning sickness, they cured that too!
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My husband and I had been trying to get pregnant for the past two years. I had undergone three rounds of Clomid with no success and the doctor was talking about IVF. We didn’t have the money for that, so we tried acupuncture. They took a lot of time to explain what they were doing with the acupuncture and Chinese herbs. I learned so much about my cycle and the reasons I was having trouble getting pregnant. They said it would take 3 to 6 months to get pregnant, and sure enough, after 3 months I was pregnant! It seems like a miracle to me. I’m so grateful to Raleigh Acupuncture. Thank you!!!