The environment that eggs occupy during their lengthy maturation process in the ovary has an impact on what shape they are in before meeting a sperm (with or without an IVF embryologist in attendance). They need a good blood supply, the right nutrients, the right hormone signals and the capacity to supply enough energy to the embryo.
This has important implications, particularly for eggs that are coming from slightly older ovaries (and possibly for eggs coming from women with PCOS or endometriosis). While no treatment can turn back the clock, or change the DNA, acupuncture and herbs can be used in an attempt to rejuvenate some oocyte characteristics by improving delivery of nutrition to the developing egg and enhancing its capacity to make energy (see below). While this is purely theoretical at this stage, there are some interesting findings which make it feasible (see below)
Suggested Schedule; Acupuncture once a week, Chinese herbs twice a day for 3 – 6 months
A discussion about egg quality is usually a discussion about aging. Although it is more common in older women, you don’t have to be in your 40s to have ovaries that are not producing good quality eggs or that are not responding well to IVF drugs. Your FSH may be rising as your pituitary tries to stimulate the ovary that has become less responsive, or your AMH may be low as the follicles themselves have become less active (or there are fewer of them). Some ovaries age more quickly than others and unfortunately neither acupuncture nor Chinese herbs (nor much else) can increase the number of eggs left in the ovary or change their chromosomes.
So what can you do?
We know that the blood flow to the follicles (which contain the eggs) of older ovaries is reduced at the late stages of their development, and this means that these eggs do not receive optimal oxygen or nutrition. (1)
We also know that eggs ovulated from follicles with optimal blood supply and oxygen content have higher fertilization rates and developmental potential leading to improved IVF outcomes. (2)
Acupuncture has been shown in animal studies to promote the growth of new blood vessels (angiogenesis) (3), and to specifically increase blood flow to the ovaries (4). The time when the follicles and the eggs inside them are developing is a critical time for its application; the use of certain acupuncture point combinations and a particular frequency of a gentle electrical pulse promotes blood supply through the uterine and ovarian arteries, and hence delivery of nutrition and oxygen. The aim of this procedure is to help influence the potential of the eggs to fertilise and create embryos, but until human studies are done, this is not a proven technique. Electro-acupuncture may be useful in making ovaries more responsive to hormone stimulation by reducing FSH (we are awaiting larger trials to verify this very interesting finding).
And there is another way we can influence egg quality.
We know that eggs with more energy (ATP) have a better chance of making viable embryos and that the rate of division and successful implantation of embryos has more to do with how much energy they have than with maternal age. However the mitochondria of older eggs are not so good at producing ATP. (5)
Similarly, it is known that older follicles have fewer defences against cellular damage caused by oxidative stress, (6) and that this is related to poorer IVF outcomes. (7)
Certain herbs, long used in fertility clinics all over China to address female infertility, have now been shown in laboratory studies using mice to markedly enhance mitochondrial activity and ATP production. These same herbs were shown to enhance antioxidant defenses at the cellular level. What the ancients knew from trial and error in their clinics, scientists are now discovering in their labs. (8)
Low intensity laser light has also been shown to enhance mitochondrial activity and ATP production, and to help reduce oxidative damage. (9)
In summary, while we await outcomes of human clinical trials in this area, there are several ways we might hope to influence the follicular micro-environment and attempt to rejuvenate eggs. All of these methods, while unproven in controlled and double blind trials, have been used extensively and without adverse events in Chinese medicine clinics.
- Increase blood supply (oxygen and nutrients) to the follicles with electro acupuncture
- Increase mitochondrial ATP output with certain Chinese herbs and low level laser light
- Enhance antioxidant defences with certain Chinese herbs and low level laser light
- Improve follicular response to hormone stimulation with electro-acupuncture
- Van Blerkom J et al, Hum Reprod 1997;12: 1047-1055.
- Bhal PS et al, Hum Reprod 1999;14:939-945 and Hum Reprod 2001;16:1682-1689.
- Du Y et al, Neurol Res. 2011 33(1):101-7.
- Stener-Victorin E et al, Jnl App Phys 2006, 101: 84-91
- Dumollard et al, 2007, Curr Top Dev Biol 2007;77:21-49
- Tarin et al, 2004, Mol Reprod Dev 2004;69:402-410.
- Wiener-Megnazi et al. 2004, Fertil Steril 2004;82(Suppl 3):1171-1176.
- Ko KM et al, Phytomedicine. 2006 13(9-10):636-42.
- Y Y Huang et al, Dose Response. 2009; 7(4): 358–383.