Infertility Management with Complementary Medicine

Family planning and fertility have become more commonly discussed in public as at-home fertility diagnostic tests have become more widely available to assess infertility. Products like Trak Fertility for men and Modern Fertility for women allow consumers to use a convenient diagnostic and get information on their health and ability to become pregnant.

The Centers for Disease Control and Prevention (CDC) reports that about twelve percent of American women between the ages of 15 and 44 have an “impaired ability to become pregnant or carry a baby to term.”₁ About six percent of married women are unable to get pregnant after 12 or more months of trying to become pregnant. Infertility can be difficult to measure in the population because it can be underreported and under-tested on a population level, but the CDC estimates that infertility affects up to 8.5 million American women.₁

As the general population gains awareness of infertility and their own fertility status, strategies to improve fertility are also growing in popularity. Methods from dietary changes to in-vitro fertilization can remedy reduced fertility. A prospective cohort study from 2010 found that, among couples seeking treatment for infertility, 29 percent had tried a complementary or alternative medicine therapy in the preceding 18 months. The most common complementary therapies were acupuncture, which was used by 22 percent of those who had tried complementary therapies, and herbal therapies, used by 17 percent of those who sought complementary therapy.₂

Fertility is influenced by many factors, including genetics and epigenetics, stress and hormones, lifestyle, and a person’s social and physical environment. If a couple is struggling to become pregnant, any one of these causes may be involved, so working with a healthcare practitioner who is experienced in fertility treatments can be very helpful. A qualitative study conducted in Canada in 2011 involved semi-structured interviews with ten complementary and alternative medicine providers who specialized in fertility medicine.₃ They included naturopaths, acupuncturists, traditional Chinese medicine providers, and more. The providers described stress as a major contributing factor to women being unable to get pregnant, but because infertility can be multifactorial, they tend to use a personalized therapeutic strategy to treat couples that experience infertility.

Integrative Medicine

Another important theme that emerged from the qualitative study was that complementary medicine providers report having limited interaction with conventional Western medicine doctors. They expressed interest in taking a more integrative approach to managing fertility issues. Similarly, people who seek complementary therapies for infertility have affirmed their experience with their complementary providers as “affirming and empowering.”₄ Women who were interviewed in a recent study indicated that the positive relationships they built with their complementary therapy providers contributed to their adherence to their therapies. In many cases, women who seek complementary therapy for fertility have already unsuccessfully tried conventional remedies for infertility.

Taking an integrative perspective of the “whole person” can be very helpful in improving reproductive health. Unfortunately, women who seek complementary or alternative therapies for infertility may be reluctant to tell their conventional medical providers that they have pursued alternative medicine.₄ Another study found that most women who seek complementary therapies for infertility also seek treatment from at least one conventional medicine provider.₅ Indeed, women who saw a primary care physician or obstetrician for pre-pregnancy care were more likely to consult with an acupuncturist than were those who did not see a physician.

Acupuncture Therapy

Acupuncture has been studied in greatest depth when it comes to complementary therapies for infertility. One randomized controlled trial included women who were having trouble becoming pregnant who were assigned to receive a lifestyle intervention with or without acupuncture for three months.₆ In addition to the acupuncture therapy, the lifestyle intervention included dietary counseling and other education. After the three-month intervention, the women who had had acupuncture therapy in addition to the lifestyle intervention conceived within five and a half weeks, on average. Alternatively, the women who did not receive acupuncture conceived within 10.7 weeks, on average. While the exact physiological mechanisms of acupuncture for improving fertility are not known, the women who got the acupuncture therapy reported increased awareness of their fertility, menstrual cycles, and general wellbeing, compared to those who did not receive acupuncture. This result suggests that there is a significant intersection of physiological and psychological health when it comes to fertility.₆

Lifestyle Medicine

As in many conditions, lifestyle medicine can also have a large impact on improving outcomes in reproductive health. Adopting a healthful dietary pattern, eliminating alcohol, reducing stress, staying physically active, and maintaining a healthy weight are lifestyle changes that can improve fertility. Rigorous scientific analyses of complementary therapies are lacking when it comes to fertility and reproductive medicine. Complementary therapies like acupuncture and nutrition therapy are typically low risk and non-invasive, but the pre- and peri-conceptual periods require specific study and analysis. People who seek complementary therapies for infertility are typically wealthier and more educated than average, so expanding access and offerings to lower income individuals may also be an important priority for expanding the field of alternative medicine for fertility.

References

1. Centers for Disease Control and Prevention Staff. (2016, July 15). FastStats – Infertility. Retrieved from https://www.cdc.gov/nchs/fastats/infertility.htm
2. Smith J., Eisenberg M., Millstein S., et al. (2010, May 1). The use of complementary and alternative fertility treatment in couples seeking fertility care: data from a prospective cohort in the United States. Fertility and Sterility 93:7. 2169-2174. https://doi.org/10.1016/j.fertnstert.2010.02.054
3. O’Reilly, E., Sevigny, M., Sabarre, K. A., & Phillips, K. P. (2014). Perspectives of complementary and alternative medicine (CAM) practitioners in the support and treatment of infertility. BMC complementary and alternative medicine, 14, 394. https://doi.org/10.1186/1472-6882-14-394
4. Rayner, J., McLachlan, H.L., Forster, D.A. et al. (2009). Australian women’s use of complementary and alternative medicines to enhance fertility: exploring the experiences of women and practitioners. BMC Complement Altern Med 9, 52 . https://doi.org/10.1186/1472-6882-9-52
5. Steel, A., Adams, J., Sibbritt, D. et al. (2012). Utilisation of complementary and alternative medicine (CAM) practitioners within maternity care provision: results from a nationally representative cohort study of 1,835 pregnant women. BMC Pregnancy Childbirth12, 146. https://doi.org/10.1186/1471-2393-12-146
6. Cochrane, S., Smith, C. A., Possamai-Inesedy, A., & Bensoussan, A. (2016). Prior to conception: the role of an acupuncture protocol in improving women’s peproductive functioning assessed by a pilot pragmatic randomised controlled trial. Evidence-based complementary and alternative medicine : eCAM. https://doi.org/10.1155/2016/3587569