The stress factors that acupuncture addresses stems from both psycho-emotional factors as well as physical etiologies. For example, extremely painful pre-menstruum or mid cycle pain can be debilitating. This type of physical stress, no doubt produces emotional stress as a result of missed work, manifest pain and other life-style factors resulting from such extreme pain; all can mitigate function of reproductive system.

Aceto corticotropic hormone is released as a response to acupuncture needle stimuli. ACTH has an antiinflammatory mechanism which may for example, help with tubal factor based infertility as a response to pelvic inflammatory disease.

The insertion of acupuncture needles has been shown to effectively increase blood circulation. Acupuncture is very effective in treating, for example, Reynaud's Syndrome. Enhanced microcirculatory patency to uterine lining does, undoubtedly contribute to a healthier and more growth oriented endometrium, especially when utilizing electrical stimulation on inserted acupuncture needles on points known as zigongxue which reside superior to ovaries. The points zigongxue are located 3 inches inferior to umbilicus and three inches bilateral to anterior midline.

"They reviewed existing evidence regarding role of acupuncture in treatment of infertility, and identified a number of studies indicating that acupuncture can be beneficial as an adjunct to other infertility treatments, including IVF. Only one randomized controlled study examined independent effect of acupuncture on IVF outcomes, but this indicated a positive effect.

The reviewed authors also highlight evidence that shows effects of acupuncture may be mediated through neuropeptides that influence gonadotropin secretion, which could in turn affect menstrual cycle. The technique can also reduce stress, which is known to adversely affect fertility, and has been implicated in regulation of uterine blood flow."

"Using acupuncture during assisted reproduction may improve pregnancy rates, say researchers. However, they acknowledge that mechanism behind this effect is unclear, and team plans to carry out further studies to confirm, and further investigate, their findings.

Noting that acupuncture has been shown to affect autonomic nervous system, Dr. Wolfgang Paulus (Christian-Lauritzen-Institut, Ulm, Germany) and colleagues postulated that therapy could increase endometrial receptivity via control of related muscles and glands.

The researchers randomly assigned 160 women receiving assisted reproductive therapy to undergo IVF with or without acupuncture, before and after embryo transfer. In acupuncture subjects, needles were placed at points believed to influence reproductive factors, for example by improving blood flow to uterus.

Paulus et al report that acupuncture group had a higher rate of pregnancy compared with those not given acupuncture (43 percent versus 26 percent). They conclude, therefore, that acupuncture could be "a useful tool" for improving pregnancy rates during certain infertility treatments."

In Part III we will look at combined elements of Eastern and Western medicine along with herbal medication in treatment of infertility.

Some formulae contain two herbs and some thirty or more herbs. Each herb has many functions. Each herb has its own flavor, nature, temperature and trophism. Prescribing correct herbal medicinals requires extensive training and clinical experience.

Self-medicating with herbal medicine presents a dual dilemma. At best herbs will be useless, as key to correct formula prescription is an accurate differential diagnosis which can only be rendered by a licensed, board certified, experienced practitioner. At worst case, self-prescribing of herbal medicine may prove harmful or fatal.

A good example of this is Ma Huang/Ephedra. Ma Huang is an herb prescribed on a daily basis by hundreds of TCM practitioners to thousands of patients safely.

That several people have died as a result of taking Ma Huang has nothing to do with dangerous properties of herb, rather with fact that in all cases of fatalities individuals were self-medicating, without directions from a doctor required for appropriate applications and contraindications. Aspirin can also prove fatal if taken by a hemophiliac. This is not an indication that aspirin should be banned or that it is a dangerous drug, but that it is unsafe if used inappropriately and safe if used appropriately.

Not only is herbal medicine safe, it is highly effective in treating much pathology without concomitant adverse effects which often accompany pharmaceutical drugs. There are many hospitalizations and fatalities which occur yearly as a result of adverse reactions to biomedicine. The occurrence of adverse reactions to herbal medicine is far less.

I have used herbal formulae repeatedly to lower elevated FSH levels, to regulate irregular menstrual cycles, to mitigate pain in endometriosis patient; to mitigate pain in patient who presents with ovulation and/or menstruation related migraines; to thicken an unresponsive endometrium; to treat amenorrheic; oligomenorrheic patient; to treat patients with partial tubal occlusion; and patient who presents with idiopathic infertility. Additionally, I have successfully treated male factor infertility, which includes presentations such as low sperm count and poor motility.

Clearly, further research is needed to fully understand mechanisms of action of acupuncture and herbal medicine in treating infertile patient. Nevertheless, it is my opinion that best-case scenario for most patients is to offer them every reasonable option which may serve to successfully address their presentation. Based upon empirical evidence of my practice in which I specialize in treatment of infertility, integration of acupuncture and herbal medicine into treatment protocol from a clinical perspective makes sense.