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Acupuncture for fertility: Doctors say, 'Why not?'

With more patients asking for it, some clinics are offering the ancient technique.

July 04, 2005|Elena Conis | Special to The Times

Jackie Apuzzo is 16 weeks pregnant -- something she was beginning to think would never happen.

Following nine years of unsuccessful efforts to have a baby, including failed in vitro fertilization, a miscarriage and a diagnosis of endometriosis, the 37-year-old social worker finally visited an acupuncturist on the advice of a friend. After two months of acupuncture treatments and a regimen of Chinese herbs, she became pregnant.

"I was a little apprehensive about the needles at first," said Apuzzo. But in April, Apuzzo's acupuncturist in Santa Monica looked at her tongue, checked her pulse and declared the Long Beach resident pregnant. Apuzzo later confirmed the diagnosis with a blood test.

As more women than ever delay having children until their 30s and 40s, infertility is a growing challenge in the U.S. An estimated 3 million couples are unable to conceive after a year of trying, according to the American Society for Reproductive Medicine. Fertility clinics have done a brisk business in recent years, but now doctors say that a growing number of women who have been unable to get pregnant through conventional medical treatments are seeking out alternatives such as acupuncture. Demand for the traditional Chinese method is so great that an increasing number of fertility doctors now are collaborating with acupuncturists, with some physicians adding acupuncturists to their staff, according to doctors and experts in the field.

Although many acupuncturists and doctors of oriental medicine swear by the treatment -- and have relied on it as an infertility remedy for years -- the mainstream medical community remains divided on acupuncture's efficacy. Some doctors say more research is needed to demonstrate acupuncture's effectiveness, and others believe it's irresponsible to recommend the treatment based on the existing scientific evidence.

Most fertility specialists trace the current popularity of acupuncture treatment to a German study published in 2002 in the journal Fertility and Sterility. The study, led by Dr. Wolfgang Paulus at the University of Ulm, found that 42% of women receiving acupuncture just before and after an assisted-reproductive therapy, such as IVF, became pregnant; that compared with 26% of patients who got pregnant with assisted-reproductive treatments but who received no acupuncture therapy.

Later that year, Dr. Raymond Chang and colleagues at Cornell University's medical school in New York published a paper in the same journal, describing several ways acupuncture might actually improve a woman's chances of conceiving: relaxation, regulating reproductive hormones and improving the lining of the uterus, where the embryo needs to be implanted before it can develop.

Because of the reports, published in a prestigious journal, "some doctors started to say, let's try it out," said Dr. Paul C. Magarelli, a fertility specialist in Colorado Springs, Colo.

Deming Huang, an acupuncturist at Stanford University's Center for Integrative Medicine in Palo Alto, said patient interest began to rise about the same time. At the Stanford clinic, more women began asking their doctors for referrals to acupuncturists. And though it's not easy to measure the effect of popular culture on medical trends, more than a few women may have been swayed to try acupuncture when the "Sex and the City" character Charlotte visited an acupuncturist in an effort to get pregnant during the show's final season.

Alice Domar, director of the Mind/Body Center for Women's Health at the Boston IVF fertility clinic, describes efforts by physicians to recommend acupuncture for fertility treatments as a "mini-scandal." But even the clinic where she works is preparing to hire an acupuncturist to add to its current mix of relaxation and confidence-building techniques for fertility patients -- a decision Domar, a psychologist, says she struggles with as a scientist.

"With the data we have right now, one cannot say that acupuncture increases pregnancy rates," Domar said. Western studies on the topic have so far produced inconsistent results, making it impossible, she said, for experts to draw definitive conclusions.

Early studies on the subject suggested acupuncture might increase blood flow to the uterus -- which would improve the chances of a pregnancy taking hold -- but later research refuted this.

Studies led by Magarelli, the Colorado specialist, suggested acupuncture increased pregnancy rates in patients who doctors had determined had little hope of getting pregnant. He and colleague Diane Cridennda, a licensed Colorado Springs acupuncturist, also showed that women who received acupuncture had more "take-home babies." That is, they were less likely to lose pregnancies to miscarriage or embryos that failed to take hold in the uterus.

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