Acupuncture: An Alternative Approach to Infertility

Anna Clark

While the notion of “infertility treatment” typically conjures images of invasive insemination procedures, acupuncture has been used for thousands of years to increase the chances of natural pregnancy. Indeed, many contemporary acupuncturists are pairing their personalized practice of needles with herbal treatments to enhance the fertility of their patients … and finding high rates of success.

While the notion of “infertility treatment” typically conjures images of invasive insemination procedures, acupuncture has been used for thousands of years to increase the chances of natural pregnancy. Indeed, many contemporary acupuncturists are pairing their personalized practice of needles with herbal treatments to enhance the fertility of their patients … and finding high rates of success.

Acupuncture draws from traditional Chinese medicine, which views physical symptoms as caused by alterations in the flow of the body’s qi (pronounced “chee”), or energy, whether by illness, stress, or other factors. By placing very small, fine needles into particular points of the body called the energy meridians, acupuncture shifts the qi to restore balance. It is used to treat a host of health care needs, including chronic pain, insomnia, allergy symptoms, stress, and smoking cessation.

When it comes to infertility treatment, acupuncture stands apart from traditional Western practices in that it is not a medical intervention; rather, it is process-oriented. The personalized care consists of regular acupuncture sessions and a regiment of Chinese herbs, as well as coaching on diet. Patients typically visit their acupuncturists at least once a week. For most patients, pregnancy happens within six months after beginning treatment; some happen much more quickly, some take longer, and still others, of course, simply do not happen. Unlike Western treatment with assisted reproductive technology, which often requires patients to take strong fertility drugs, there are nearly no side effects to acupuncture.

At the Acupuncture Center for Reproductive Health in New Jersey, Candace Jania said that her practice is made up of about 90 percent people who are looking to enhance their fertility. Nearly all of her patients come by her practice through personal referral. Many of her patients have already been through Western procedures, including intra-uterine insemination and in vitro fertilization, while others hope to improve their chances for conception naturally before moving on to more expensive and complicated strategies. Some patients practice both acupuncture and IUI/IVF at the same time. For 2009, the total rate of pregnancy success of all patients the ACRH treated was 73 percent  By comparison, the American Society for Reproductive Medicine reports an IVF success rate of 29.4 percent per egg retrieval, and a delivery rate of about 30 percent. More research is being done to explore the influence of acupuncture on fertility, as well as the influence of acupuncture paired with IUI/IVF.  Some peer-reviewed studies are finding that acupuncture boosts fertility in both women and men, while some contend that if it has no measurable effect but at least does no harm. It is, however, difficult to assess the effectiveness of a traditional Chinese form of medicine with the strictures of Western research, and more investigation continues to be done.

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Most of ACRH’s patients stay with the clinic throughout their pregnancy because, Jania said, the acupuncture treatment also reduces the risk of miscarriage, eases morning sickness, and lessens the chances for a complicated labor.

“Acupuncture treatments help tremendously on so many levels, from beginning to end,” Jania said.

Beyond her vantage as a specialist, Jania speaks from personal experience; she went through IVF when she conceived her first child back when she was just beginning to pursue her career as an acupuncturist. The IVF attempts were “really tough” on her body, Jania said.  Later, when she went back to her endocrinologist to discuss a second pregnancy, she asked what her chances were of conception happening naturally. “None,” she was bluntly told.

Jania went on to an acupuncturist. She and her husband both began taking herbs. With no invasive treatment, she was soon pregnant with her second son – who she calls “my Chinese herb baby.”

“I’ve experienced both sides of the coin,” Jania said, which puts her in a position to better facilitate the experiences of her patients who are navigating both Eastern and Western fertility treatments; she collaborates with a reproductive endocrinologist for patients who are doing both treatments simultaneously.

While infertility causes can rest with people of either sex, Jania’s clientele skews heavily female – at an 80/20 ratio.

“Men are harder,” she said. “Many only come because their wives wanted them to come, though they enjoy it when they’re here.”

Julie Ormonde at Auburn Community Acupuncture, is more straightforward about the skewed gender ratio that she sees mirrored in her own clinic: “Usually men come kicking and screaming—unless the man is really on board with fertility and with having a baby.”

For Ormonde, acupuncture fertility treatment is ultimately about balance. At her clinic, she emphasizes a unique process for each patient, drawing from the information that she can learn by reading temperature charts and cervical mucus.

“Most women have a period and cervical mucus and they don’t pay any attention to it,” Ormonde said. “Is it clotted, bright red, dark red? This tells us an incredible amount of information. … (and) so much in-depth information is needed for fertility treatment because there are so many variables in fertility.”

Her work has convinced her that there is a broad general confusion about how pregnancy even happens.

“Western medicine doesn’t do a lot of teaching about how you get pregnant,” Ormonde said. “Schools don’t do this either. People really don’t know how to get pregnant. They’re never taught how to take control of their cycle; they don’t know about temperature charts and mucus.

“We’re supposed to teach sex ed in classes, but we don’t teach this,” Ormonde added, noting that this same information is meaningful for understanding how not to get pregnant. “A lot of people get pregnant fairly quickly once they learn when to have sex based on their body.”

Ormonde herself came to acupuncture after suffering from narcolepsy. After a long series of Western treatments and specialists, she took a chance on Eastern needles and herbs in 1997. While narcolepsy is considered an incurable disease, Ormonde found quick relief as her sleep patterns stabilized during acupuncture treatment. She hasn’t experienced her former symptoms in the thirteen years since.  Later, when Ormonde was ready for pregnancy, she used acupuncture to regulate her menstrual cycles and was able to facilitate her own fertility.

But despite the potential for acupuncture treatments for infertility, its widespread use as a positive alternative–or perhaps complement–to assisted reproductive technology is hindered by the systematic segregation of acupuncture as viable health care.

Acupuncture is not covered by many health insurance companies for fertility treatments or anything else – making services at traditional clinics, which cost $100-$200 per individual session far too expensive for many people (even though they remain much more affordable than IUI/IVF treatments).

Community acupuncture clinics like Ormonde’s are premised on making this potent form of care accessible and affordable to as many people as possible. In a strategy that may help fill the gap, these clinics offer acupuncture services in a communal setting that are provided on a sliding scale of $15-$45.

“One of my issues with acupuncture was, as an acupuncturist, I could not afford to get it myself,” Ormonde said about her early years practicing in traditional settings.

When she came by the community model of practice, she embraced it. “When I started, there were just a few clinics doing this. Now it’s just blossomed into an incredible movement.”

But even as the community acupuncture movement is developing rapidly—there are more than 120 community clinics across the nation, and the number is growing—large swaths of the United States still don’t have one available to them. Therefore, because of costs, acupuncture is not always a feasible source of care for those struggling with infertility.

Changes in the Medicare bill could alter this; it’s possible the new version of it will include coverage for alternative medicine, including acupuncture.

Congressman Maurice Hinchey (D-NY) has re-introduced legislation every year that he’s been in Congress—since 1993—that would make acupuncture a covered service for the 44 million Americans on Medicare.  When he again brought the bill forward last year, Hinchey said that, “It is entirely unacceptable that Medicare and the Federal Employees Health Benefits program don’t cover acupuncture treatment and thus force plan participants to forego acupuncture or pay for it entirely out of their own pocket … In a country as great as ours no American should ever be denied access to any legitimate forms of medical care that can make them healthier and more comfortable.”

The number of co-sponsors to this bill has steadily increased each year since Hinchey first introduced it. If and when Medicare is adapted to include acupuncture, it will pose a compelling pressure for other health insurance agencies to follow suit and expand their coverage to do the same.

Another obstacle to widespread acceptance of acupuncture as a viable fertility treatment comes down to simple fear of needles, according to Jania.

“It’s a huge barrier,” said Jania of this fear. “People have a scary image in their minds, but (we don’t use) hypodermic needles; our needles are about the size of a hair.”

Nonetheless, misconceptions about acupuncture needling as an ominous or painful treatment may compel many to avoid it and ironically, to turn to riskier and more invasive infertility procedures.

In addition, acupuncture is an infertility treatment that requires a certain amount of patience—another turn-off for some people who are anxious for pregnancy.

“Western medicine is fabulous at taking something and forcing it to happen,” Ormonde said. “Chinese medicine is about re-balancing the body to help the body get pregnant naturally. That takes time. I can’t give it to you in one month.”

It takes an average of six months for people receiving acupuncture treatment to become pregnant. If time truly is short—that is, depending on the age and medical history of the patient—Ormonde may recommend simultaneous treatment with Western fertility clinics. These clinics she noted, are becoming more receptive and respectful to her own work as they see positive outcomes from acupuncture.

The effectiveness of acupuncture can’t be well put to standard Western proofs. While Western medicines are often tested in standardized double-blind studies, there is no clear way to similarly apply scientific controls to test acupuncture. At the same time, the nature of the practice resists formula; each treatment is very much personalized, making generalizations from test results somewhat futile.

There is no single acupuncture prescription for infertility; even as there are common elements in the treatment process, it is always uniquely tailored to the biology and needs of each patient. Auburn Community Acupuncture offers an FAQ section on its website that provides responses to questions about how acupuncture can influence fertility, specifically enumerating the reproductive issues that it can be used for, from endometriosis to irregular menstrual cycles to recurrent miscarriage.

Ormonde noted that if acupuncture didn’t work, it’s unlikely it would have been around for as many years as it has.

“Things don’t last 5000 years if they don’t work,” she said.

Jania echoed this idea – and suggested that acupuncture may be that it is due for a surge of popularity, having no less of a mainstream endorsement than Dr. Oz.

“It’s hard for me to explain the passion I feel for this medicine,” Jania said. “It has save me time and time again. I wish more people experienced it.”

News Health Systems

What Happens When a Catholic-Run Clinic Comes to Your Local Walgreens?

Amy Littlefield

“It causes us great concern when we think about vulnerable populations ... [who] may need to use these clinics for things like getting their contraception prescribed and who would never think that when they went into a Walgreens they would be restricted by Catholic doctrine,” Lorie Chaiten, director of the women’s and reproductive rights project of the ACLU of Illinois, told Rewire.

One of the largest Catholic health systems is set to begin running health clinics inside 27 Walgreens stores in Missouri and Illinois next week. The deal between Walgreens and SSM Health has raised concerns from public interest groups worried that care may be compromised by religious doctrine.

Catholic health systems generally follow directives issued by the U.S. Conference of Catholic Bishops that restrict access to an array of services, including abortion care, contraception, tubal ligations, vasectomies, and fertility treatments.

“We are concerned that the clinics will likewise be required to follow the [directives], thereby severely curtailing access to important reproductive health services, information, and referrals,” MergerWatch, the National Health Law Program, and the American Civil Liberties Unions of Illinois and Missouri wrote in a letter to Walgreens on Wednesday. They also sent a letter to SSM Health.

In a statement emailed to Rewire, Walgreens said its relationship with SSM Health “will not have any impact on any of our current clinic or pharmacy policies and procedures.”

SSM Health emailed a statement saying it “will continue to offer the same services that are currently available at Walgreens Healthcare Clinics today.” If a patient needs services “that are beyond the scope of what is appropriate for a retail clinic setting, they will be referred to a primary care physician or other provider of their choice,” the statement read.

A spokesperson for SSM Health demurred when Rewire asked if that would include referrals for abortion care.

“I’ve got to check this part out, my apologies, this is one that hadn’t occurred to me,” said Jason Merrill, the spokesperson.

Merrill later reiterated SSM Health’s statement that it would continue to offer the same services.

Catholic health systems have in recent years expanded control over U.S. hospitals, with one in six acute-care hospital beds now in a Catholic-owned or -affiliated facility. Patients in such hospitals have been turned away while miscarrying, denied tubal ligations, and refused abortion care despite conditions like brain cancer.

Catholic health systems have also expanded into the broader landscape of outpatient services, raising new questions about how religion could influence other forms of care.

“The whole health system is transforming itself with more and more health care being delivered outside the hospital,” Lois Uttley, director of MergerWatch, told Rewire. “So we are looking carefully to make sure that the religious restrictions that have been such a problem for reproductive health care at Catholic hospitals are not now transferred to these drug store clinics or to urgent care centers or free-standing emergency rooms.”

Walgreens last year announced a similar arrangement with the Catholic health system Providence Health & Services to bring up to 25 retail clinics to Oregon and Washington. After expressing concerns about the deal, the ACLU of Washington said it received assurances from both Walgreens and Providence that services at those clinics would not be affected by religious doctrine.

Meanwhile, the major urgent care provider CityMD recently announced a partnership with CHI Franciscan Health–which is affiliated with Catholic Health Initiatives–to open urgent care centers in Washington state.

“We’re seeing [Catholic health systems] going into the urgent care business and into the primary care business and in accountable care organizations, where they are having an influence on the services that are available to the public and to consumers,” Susan Berke Fogel, director of reproductive health at the National Health Law Program, told Rewire.

GoHealth Urgent Care, which describes itself as “one of the fastest growing urgent care companies in the U.S.,” announced an agreement this year with Dignity Health to bring urgent care centers to California’s Bay Area. Dignity Health used to be called Catholic Healthcare West, but changed its name in 2012.

“This is another pattern that we’ve seen of Catholic health plans and health providers changing their names to things that don’t sound so Catholic,” Lois Uttley said.

 

In the letters sent Wednesday, the National Health Law Program and other groups requested meetings with Walgreens and SSM Health to discuss concerns about the potential influence of religion on the clinics.

“It causes us great concern when we think about vulnerable populations, we think about low-income people… people who… may need to use these clinics for things like getting their contraception prescribed and who would never think that when they went into a Walgreens they would be restricted by Catholic doctrine,” Lorie Chaiten, director of the Reproductive Rights Project of the ACLU of Illinois, told Rewire.

The new clinics in Walgreens will reportedly be called “SSM Health Express Clinics at Walgreens.” According to SSM Health’s website, its initials “[pay] tribute” to the Sisters of St. Mary.

“We are fairly forthcoming with the fact that we are a mission-based health care organization,” Merrill told Rewire. “That’s something we embrace. I don’t think it’s anything we would hide.”

 

Tell us your story. Have religious restrictions affected your ability to access health care? Email stories@rewire.news

News Violence

Fetal Tissue Workers Sue to Stop David Daleiden From Getting Their Names

Nicole Knight

The plaintiffs' lawyer explained that the researchers, who remain anonymous in the complaint, “are very fearful that they may be subjected to the same type of harassment and violence” that abortion clinic employees have faced.

Employees and scientists with ties to the University of Washington’s Birth Defects Research Laboratory have won a temporary reprieve in federal court barring the release of their personal information to anti-choice activist David Daleiden and his cohorts.

Federal judge James L. Robart granted the restraining order on Wednesday, after the plaintiffs filed a class action lawsuit to block the release of a trove of documents requested by Daleiden and a representative from a Washington state anti-choice group. The unredacted records reveal the individuals’ identifying information, such as names, addresses, and phone numbers, according to court documents.

A hearing on a permanent order is expected later this month in U.S. District Court for the Western District of Washington.

Using the Washington state Public Records Act, Daleiden and Zach Freeman, communications director with the anti-choice Family Policy Institute of Washington, had sought records dating back to 2010 related to work at the Birth Defects Research Laboratory. The research laboratory collects, processes, and distributes fetal tissue for research at academic and nonprofit institutions nationwide, according to court documents. Also ensnared in the sweeping document request were various medical and bioscience institutions, including Seattle Children’s Hospital and Planned Parenthood affiliates.

Daleiden had requested purchase orders, invoices, emails, grant applications, contracts, materials transfer agreements, rent/lease agreements, and other documents, according to an exhibit in court documents.

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Janet Chung, counsel with Seattle-based Legal Voice, who is representing the plaintiffs, said her clients wanted to stop the release of the unredacted records.

Daleiden, a self-proclaimed investigative journalist and head of the California-based anti-choice group Center for Medical Progress, was formerly indicted for his role in a string of discredited “sting” videos falsely accusing Planned Parenthood of profiting from fetal tissue donations.

Reached by phone on Friday, Chung explained that the plaintiffs, who remain anonymous in the complaint, “are very fearful that they may be subjected to the same type of harassment and violence” that abortion clinic employees have faced, particularly after the publication of the CMP videos. Releasing the unredacted records would violate the plaintiffs’ constitutional right to privacy and free association, according to the complaint.

Chung called Daleiden and Freeman’s records request a “fishing expedition” intended to “harass and intimidate.”

In an emailed statement, Daleiden said he is seeking the “truth” about a “cover-up” at the University of Washington.

When Rewire asked Daleiden whether he objected to redacting identifying information, such as names and addresses, he said in an email that his records request in February did not ask for the “personal contact information of any individuals whatsoever.”

As he explained to Rewire, however, he is seeking the communications of eight individuals whom he considers public figures:

My request only seeks those of 8 public figures…who are very publicly identified with their work at [Birth Defects Research Laboratory] with fetal body parts or with Planned Parenthood’s abortion program in Washington state.

The eight “public figures” that Daleiden names include a retired birth defects researcher, a research director at Seattle Children’s Hospital, and a top executive at Planned Parenthood.

Chung, however, told Rewire that Daleiden’s request was so broad that releasing the records would disclose the personal information of more than 150 individuals.

Chung said the plaintiffs resorted to court action because the state public records law doesn’t necessarily require the redaction of personal information, and the University of Washington had warned that it would release the records on August 5.

About two weeks before filing the complaint, Chung said they’d discussed redacting the documents with Daleiden, but he declined. She said they’re continuing to try to resolve the matter with Daleiden’s legal counsel.

In affidavits included with the complaint, plaintiffs claim they’ve been threatened, harassed, and exposed to violence —even murder—due to their ties to fetal tissue research.

As an employee at Seattle Children’s Hospital, identified only as John Doe 1 to protect his privacy and safety, writes:

In one case, Seattle Children’s diagnosed a fetus with a lethal disorder, and because of number of weeks of gestation, the patient had to travel out of state to obtain an abortion. I had interactions with the physician who performed the abortion relating to the autopsy that Children’s Labs performed on the fetus. That physician was later killed by someone with anti-abortion views.

In another affidavit, a professor and research scientist who studies congenital birth defects and is identified as Jane Doe 8, writes:

I fear that having my identity and personal information released to the public would lead to harassment, threats, or violence directed against me or my family.

Protecting the privacy and safety of researchers and employees with ties to fetal tissue science has emerged as an issue of growing concern among scientists as anti-choice groups and Republican lawmakers march on with what some have called a Planned Parenthood “witch hunt.”

In June, the head of the U.S. House Select Investigative Panel on Infant Lives revealed fetal tissue scientists’ identities in letters sent to U.S. Department of Health and Human Services—prompting fears in the medical research community the individuals will be subject to harassment and violence by anti-abortion activists.

As Chung told Rewire, “This is all very much rooted in the concern that the same types of harassment and violence that clinics experience are now being targeted on a wider range of people—all with the goal of chilling important research and medical care.”

The lawsuit is the fourth filed against Daleiden and his anti-choice group following the release of the first wave of CMP’s sting videos last summer. Planned Parenthood Federation of America, the National Abortion Federation (NAF), and StemExpress, a fetal tissue processing firm that once worked with Planned Parenthood, have all sued in federal court in California.

Daleiden often frames his work as citizen journalism, but in a brief filed with the NAF lawsuit, 18 of the country’s leading journalists and journalism scholars noted that “calling himself an ‘investigative journalist’ … does not make it so.”

In April, California Attorney General Kamala Harris’ office searched Daleiden’s California apartment as part of an ongoing investigation into the CMP’s secret recording methods.

Officials in a dozen states, including Washington state, have cleared Planned Parenthood of any wrongdoing in its tissue donation programs, and eight additional states have declined to investigate the health-care provider.

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