Acupuncture and other fertility factors

Fertility hormones: We have reason to believe that acupuncture-induced signals make their way to the brain and affect areas like the hypothalamus (which is at the top of the control center for the production of many fertility hormones). Dialing up or down the activity of the hypothalamus can therefore affect levels of hormones like FSH and LH, which are crucial for ovulation (and thus for conception).

Direct evidence from large-scale studies of acupuncture affecting reproductive hormones in people is scant, probably in no small part because of the logistical and financial challenges of studying personalized treatments in the context of large-scale studies. But studies of female rats do find that acupuncture affects almost all reproductive hormones. Specifically, one recent study found that acupuncture administered to female rats every three days for a total of 15 days altered almost all reproductive hormones they looked at. We have yet to see how applicable this is to humans, who are a different species and have different treatment regimens. 

Thyroid function: Hormones related to thyroid function may impact fertility outcomes, meaning thyroid function may be an important thing to keep in check for people who are trying to conceive. Some reviews have suggested a beneficial impact of acupuncture on thyroid function.

Breech Babies and Moxibustion

As a baby develops, the amount of room in the uterus for them to move decreases. At about 32-34 weeks, medical practitioners start to be concerned if the baby hasn't naturally turned to a head-down position. If the baby doesn't turn, it is called a breech presentation. Breech presentations can make birthing person's delivery more difficult and many medical providers may not be experienced in delivering a breech baby vaginally.  Only the baby can turn the baby, however we can work together to create the optimal conditions for baby to turn.

I recommend the following weekly regimen, starting at week 32, to help a baby to turn naturally. Usually treatments have to be done before week 38 so that the baby has enough room in the uterus to move. This is a very relaxing session which includes moxibustion (or "moxa") near your baby toe to stimulate your baby to move. Moxibustion is a therapy of burning dried mugwort near particular points to warm regions of the body and stimulate circulation.

Traditional Chinese Medicine (TCM) has been shown in clinical trials to be effective at turning a breech baby naturally. Western medicine can't explain why acupuncture is so effective at turning breech presentations, but it has been working for over 3000 years.

Preparing for Labor with Acupuncture

As a medical term, "labor induction" means leading the patient into labor, by initiating contractile activity. I avoid the phrase, not because acupuncture can't initiate contractions--it can, as we have seen--but because in most cases where contractions haven't started spontaneously there's a reason why. Challenges of position, hormonal activity, cervical ripening and/or emotional preparedness cause delayed labor onset more often than simple lack of contractions. Accordingly, most moms benefit more from preparatory work based on their personal situation, than from generic stimulation of contractions.

For pregnant persons who wish to avoid medical intervention to start labor, but who are near or over term, acupuncture can be effective in helping the birthing person and baby to reach the right level of energy and balance of hormones to advance towards labor.

Research studies in the last 10 years have helped us understand the role acupuncture can play in labor and delivery. Studies show that acupuncture treatments can relieve labor pain, promote uterine contractions, shorten the birth process, and treat postpartum disorders. These clinical findings were the result of acupuncture's ability to influence serum levels of prostaglandins, estrogen, and oxytocin along with stimulating uterine contractility.     

To help prepare for labor, I perform an acupuncture treatment which is very relaxing and also helps the birthing person prepare mentally for labor. I suggest beginning treatment to stimulate the transition into labor starting at 36 weeks. Once per week acupuncture these last few weeks of pregnancy allow enough time for the acupuncture stimulation to have a gentle but significant effect on the hormone changes involved. If a person waits until their due date or past due, they will need to receive treatments daily in order to maintain the momentum created after each session. 

During the acupuncture treatment, the birthing person may notice increased movement of their baby and some contractions. Many patients experience increased contractions in the evening and night after a session. Each subsequent week or day of treatment the birthing person should have more signs that they are moving more in the direction of active labor.  The effects of acupuncture treatment are not as instantaneous as a medical induction and multiple treatments are usually necessary.

I structure my labor preparation packages to start around 30 weeks of pregnancy in order to get a head start on balancing the body's energy and addressing any aches and pains that may be occurring.  This ensures concerns can be addressed in a timely manner and that the transition in the last few weeks of pregnancy may be smoother as a result.  If you have questions about your specific situation, please reach out!

For more information and articles on this topic you can see:

Acupuncture for cervical ripening and induction of labor at term—a randomized controlled trial.

Rabl M, Ahner R, Bitschnau M, Zeisler H, Husslein P.

Wien Klin Wochenschr. 2001 Dec 17;113(23-24):942-6.

Smith CA, Crowther CA. Acupuncture for induction of labour.

Cochrane Database Syst Rev. 2004;(1):CD002962

Rabl M., Ahner R., Bitschnau M., Zeisler H., Husslein P.

Acupuncture for cervical ripening and induction of labor at term—a randomized controlled trial. Wien Klin Wochenschr. 2001 Dec 17;113(23-24):942-6.

PMID: 11802511

Dunn PA, Rogers D, Halford K. Transcutaneous electrical nerve stimulation at acupuncture points in the induction of uterine contractions.

Obstet Gynecol. 1989 Feb;73(2):286-90.

PMID: 2783481

In-Hospital Acupuncture or In-Home Acupuncture