Hard to Conceive

Few studies have been done on the long-term safety of herbs.

• ACUPUNCTURE

The Eastern View The classical Chinese explanation goes like this: Channels of energy called meridians run in river-like patterns through the body, nourishing the tissues. Any obstruction in their movement is like a dam, disturbing energy flow and leading to dysfunction and possibly disease. Acupuncturists say that placing needles in specific points along the meridians can unblock the obstructions and reestablish the regular flow through the body.

Lewis points to small studies that say acupuncture can restore normalcy to the endocrine system, which regulates hormones necessary for reproduction. And, she adds, acupuncture has been shown to increase blood flow to the uterus and ovaries, which can bolster the quality of the eggs they produce as well as helping encourage an embryo to implant. She added that acupuncture can also trigger ovulation. Lewis gave me three acupuncture treatments at the retreat.

The Western View Many fertility doctors remain skeptical, including mine, Frank Chang. "It just doesn't translate into Western terms," said Chang, clinical associate professor of reproductive endocrinology at George Washington University School of Medicine and medical director of MidAtlantic Fertility Centers in Bethesda. "A lot of [belief in acupuncture] is empirical observations made over centuries. Most of us have a hard time making that leap of faith; we think in terms of specific physiological changes seen in controlled studies."

But Chang and many of his colleagues remain curious. This summer, he plans to ask patients to participate in a controlled study examining whether acupuncture improves IVF outcomes. Sponsored by the University of Maryland and conducted through Chang's clinic, the study will use sham acupuncture -- in which needles are inserted at non-acupuncture sites in the body -- as a control.

If the results show the ancient Chinese remedy to have significant merit, Chang says he's open to changing his mind and will suggest his patients consider it. In the meantime, he says his patients can feel free to go for the needles if they choose: "It can't hurt you in any way, and it might help. We just don't know."

What the Studies Show As with herbs, no large, controlled studies have been done on acupuncture and fertility in the United States.

In 2002, the U.S.-based journal Fertility and Sterility published results of a German study on IVF patients who received acupuncture treatments before and after embryos were transferred into the uterus. Almost half of the 80 women who got acupuncture conceived, compared with a 26 percent success rate in the control group, which got no acupuncture. That seems convincing, but the authors themselves said psychological or psychosomatic effects could not be ruled out, adding that they plan to do a future study using a placebo needle set as a control -- similar to Chang's upcoming study.

In 2002 researchers at Cornell University conducted a meta-analysis of the scant literature on acupuncture for fertility, concluding there was not yet sufficient evidence to gauge the method's merit.

In 1997 the National Institutes of Health (NIH) issued a consensus statement saying that acupuncture had shown promising results in treating adult post-operative and chemotherapy nausea and vomiting and in post-operative dental pain. But so far, no word from the NIH on acupuncture for infertility.