For most Americans, Traditional Western Medicine is all they have ever known. Naturally, when experiencing infertility, they turn to the possible solutions offered by western medicine. However, western medicine is not the only approach available as more and more western medical practitioners open the door to alternative therapies that are widely accepted and relied upon outside of the United States.

Most times, when we think of fertility treatments, we think of the many advances that modern medicine has brought to fertility treatment centers and their patients. However, fertility treatments were not invented or popularized in the west. The benefits of acupuncture and Traditional Chinese Medicine (TCM) as treatment for infertility can be found in literature dating back to 11AD, and western medicine is only recently recognizing the benefits.

What is Acupuncture?
The ancient Chinese practice of acupuncture involves the placement of thin needles at particular points and intervals on the body to direct and stimulate the body’s vital energy (qi). In TCM, a disruption in the energy patterns is thought to cause disharmony in the body which causes it to not function properly. It is painless and has no harmful side effects.

How Does Acupuncture Affect Infertility?
Exactly why acupuncture affects infertility has failed to be understood or scientifically explained by western medicine, but many studies show that it clearly does – positively. Although the practice continues to be considered alternative medicine, many studies are being done, and the subject is gaining widespread attention. Some possible reasons for acupuncture’s favorable influence on fertility include:

• The stimulation of the central nervous system which causes an increase in neurohormones and neurotransmitters
• Changes in the nervous system which regulate body temperature
• Changes in blood pressure, regulating blood flow to reproductive organs
• The releasing of endorphins
• Stimulating egg production
• Stimulating sperm health

What Do Studies Show?
In 2002, a study conducted in Germany followed 80 women who either received both acupuncture and IVF or IVF alone. It is reported that 42% of the women receiving both treatments became pregnant, while only 26% of those receiving IVF treatments alone became pregnant. An even more recent study conducted in the U.S. followed 114 Women. The study showed some compelling results:

• 51% of the women receiving both treatments became pregnant
• 36% of the women receiving IVF alone became pregnant
• 8% of the women receiving acupuncture experienced miscarriage
• 20% of those receiving IVF alone experienced miscarriage
• The group receiving acupuncture also experienced fewer ectopic pregnancies

Western Medicine Embracing Possibilities
Although, undoubtedly, much research will continue in the area, western medicine is embracing the possibilities that acupuncture offers. In fact, many acupuncturists are seeing an increase in referrals from primary care physicians and fertility treatment center endocrinologists. Additionally, many progressive fertility treatment centers now have acupuncturists on staff.

How or why acupuncture affects the ability to become pregnant remains elusive to modern science. However, the positive impacts for many are undeniable. Many find the possible benefits, coupled with no adverse impact, make acupuncture worth investigating.

Conflicting reports concerning the Sperm Injection Fertility Method have many couples  asking their fertility treatment center for clarification. A study, involving 1,000 babies born after intracytoplasmic sperm injection, ICSI, seemingly confirmed fears that there is an increased risk of birth defects when compared to the general population of all babies conceived using some type of fertility treatment or babies born without the use of any fertility treatments.

What is Intracytoplasmic Sperm Injection (ICSI)

Used primarily in male factor infertility, the ICSI process involves the fertility treatment center embryologist first selecting viable sperm using micromanipulation tools. The sperm is then injected through the outer shell of the egg and egg membrane, then into the cytoplasm of the egg. Fertilization using this process occurs in about 85% of cases.

ICSI is Most Commonly Performed in These Cases

Although there is no specific standard of care concerning which cases should or should not use ICSI, most fertility treatment centers consider them in these common scenarios:

• When there is a concern over a low yield of egg retrieval
• For couples having already attempted IVF treatment an experienced no or low rate of fertilization
• In male factor infertility cases that do not wish to use donor sperm
• Couples with low sperm concentrations or low sperm motility

What Do Studies Show?

Several studies conducted since the procedure was introduced in 1991 have, not surprisingly, conflicting findings. In most studies, there does seem to be an increase in the rate of  birth abnormalities in those babies conceived using ICSI as opposed to those conceived naturally. The controversy lies in how those results are interpreted.

A new Swedish study published in the Journal of Human Reproduction says that fears of birth defects resulting from the procedure are largely unfounded. The study asserts that the perceived increase in the rate of birth defects is mainly attributable to, or the result of, conditions associated to multiple or premature births. About 50% of the reported cases involved only minor conditions.

One Plausible Link

However, one specific birth abnormality did seem to be over-represented. Hypospadias may possibly be attributed to ICSI and is associated with paternal fertility problems. Hypospadias is an abnormality of the penis where urine passes through an abnormally placed opening on the undersurface of the penis. The condition is not serious and can be easily treated with plastic surgery.

On Going Studies

The ICSI procedure is fairly new and ongoing studies will no doubt continue and may shed new light on this treatment. ICSI for many couples represents their greatest hope of achieving a pregnancy and undue weight should not be placed on these results. The latest studies should reassure those seeking ICSI as a fertility treatment option, rather than cause concern. Couples considering ICSI should remember that thousands of healthy, normal babies are born every year using this procedure.

Any couple considering Intracytoplasmic Sperm Injection as a fertility option should discuss any concerns they may have with their fertility treatment center doctor.

Fertility Option After Cancer Treatment – Ovarian Tissue Transplant

The development of better cancer treatments has resulted in much improved survival rates for cancer patients, which in turn, has led to many new options and concerns. One of the many concerns for young female cancer patients is the high risk of premature ovarian failure as a result of the life saving cancer treatments. The risk of ovarian failure varies depending on many factors:

•The patient’s age
•Area or field of  irradiation

Additionally, the type of chemotherapy used plays a huge role, with the group called alkylating agents posing the greatest risk. This group includes:

•Busulfan
•Chlorambucil
•Cyclophosphamide
•Ifosfamide
•Nitrosoureas
•Melphalan
•Procarbazine

Bone marrow transplantation is thought to be most responsible for ovarian failure with 80% of patients experiencing premature failure.

New Treatment Therapies
Until very recently, fertility treatment centers could offer those patients very few options. Today, one of the most exciting and promising treatment options is the cryopreservation of ovarian tissue as a method of preserving fertility. This treatment option is best for patients too young or are otherwise not a candidate for egg or embryo banking.

What is Cryopreservation of Ovarian Tissue?
Cryopreservataion of ovarian tissue is performed before radiation or chemotherapy treatments and does not require ovarian stimulation. Performed at a fertility treatment center or at an oncofertility center, an ovary is removed from the patient and then frozen. The outpatient laparoscopic procedure takes under an hour, is simple, done under general anesthesia and is not especially painful. Recovery time is minimal and patients can begin cancer treatments in a few short days after the procedure.

Usually within 5 years, after the patient is cleared of cancer, the ovarian tissue is then grafted back onto the patient’s fallopian tubes, and in many cases, restores fertility.

Areas of Concern
Patients should make sure that their physician is very familiar with medical oncology, histopathology and reproductive endocrinology. Although no cancer recurrance from ovarian grafts has been reported has been reported yet to date, it is still a concern. Not every patient is a candidate for the procedure and type of cancer plays a critical role in whether or not this therapy is a suitable option. Of particular concern is breast cancer, as this cancer metastasizes haematogenously.

A thorough evaluation of the tissue must be made to rule out any metastasis.  Additionally, a physician may find the procedure is not an option for young breast cancer patients as the patient may be harboring certain gene mutations which may also harbor a co-existing primary ovarian cancer.

The occurrence of ovarian cancer in women under the age of 35 is rare, but it is still a risk that should be considered. Patients with endometrial cancer are also not considered candidates. As promising as the treatment may be, not every treatment is right for every patient. Cryopreservataion of ovarian tissue is still a very new procedure and any concerns should be discussed with your fertility treatment center reproductive endocrinologist.