The ovary is a special reproductive organ in women. In ovaries follicles develop into oocytes; eggs are released from ovaries; remaining part of the follicles forms corpus luteum. This generates women’s menstrual cycles. There are three phases of menstrual cycles: follicular phase, ovulation and luteal phase. Each phase has distinct with featured hormone levels. The hormones are produced in three areas: hypothalamus, anterior pituitary gland and ovaries. The hypothalamus produces gonadotropin releasing hormone (GnR) which stimulates the pituitary gland. The pituitary gland produces both follicle stimulating hormone (FSH) and luteinizing hormone (LH) which stimulate the ovary. The ovary secrets estrogen and progesterone. FSH and LH inhibits production of GnRH. Low concentration of estrogen increases release of FSH from the pituitary gland. High level of estrogen decreases FSH and increases LH secretion causing LH surge. This is called hypothalamus-pituitary-ovarian axis. This axis is in control ovulation. Any dysfunction of this axis may result in anovulation and irregular period. It also can lead to infertility caused by no ovulation. The leading cause of infertility is ovulation dysfunction, either no ovulation or irregular ovulation.
Anovulatory cycle is a menstrual cycle which ovulation does not occur and there is no egg released from the ovaries. Women would think if they have periods, they must be ovulating. This is not necessarily the case. You don’t have to ovulate to have periods. This is called anovulatory cycle. The cycles could be regular with variations of period intervals. These cycles are without ovulation and a luteal phase. Anovulation is a common cause of infertility which occurs in up to 40% of infertile women. Women without ovulating may have irregular periods, or no periods. It is possible that women with regular periods have no ovulation. Once they try to conceive and they start to detect the problem. Because no egg is released and fertilization becomes impossible, the women cannot conceive. Basal body temperature charting is a valuable tool to identify anovulation.
Normal menstrual cycles are 28 days (21-35 days) with follicular phase, ovulation and luteal phase. Ovulation occurs in the middle of the cycle and corpus luteum which produces progesterone forms after ovulation. After 14 days, corpus luteum decayed and stopped producing progesterone. Uterine inner lining shed off without the support of progesterone in the case without pregnancy. This is called progesterone withdrawal bleeding. In the case of anovulation, there is no progesterone produced. Bleeding is caused by inability of oestrogen to support uterine inner lining growth. It is called oestrogen breakthrough bleeding.
There are many factors that cause anovulation and here are some common causes of anovulation.
Hypothalamus-pituitary-ovarian-axis dysfunction. This is caused by problems of hypothalamus or pituitary gland in the brain. As a result the hormones are not balanced which does not trigger ovulation and leads to infertility. The reasons that affect hormone balance include stress (see below); the other common causes are excessive exercises and/or underweight.
As we already known that subtle environmental changes may alter the menstrual cycle and cause anovulation. For example, summer camp menstrual disturbances and exam anovulation. Women in emotional stress could have no ovulation. This is temporary situation. If women get out of the stress environment, menstruation and ovulation could be returned. However if this situation is prolonged, anovulation could be persistent. Finding the causes of stress situation and avoiding the causes are the keys for ovulation to return. Many therapies could help reduce stress, such as psychological therapy, yoga and acupuncture etc.
Ovarian causes. If ovary does not respond to FSH and LH, this also causes ovulation problem.
Polycystic ovary syndrome (PCOS). This is commonest cause of anovulation related infertility. It explained 70% of the cases. Women with PCOS have imbalanced hormone levels. This may produce multiple cysts in ovaries, irregular period cycle, anovulation, infertility, acne and excessive hair growth and other symproms.
Premature ovarian failure (POF). In women with POF, their ovaries fail to function properly before menopause occurs. The ovaries don’t respond to FSH and there is no ovulation. They have difficulty to get pregnant.
Treatments that reduce stress can be effective to improve ovulation. Acupuncture helps treating anovulation by stimulating nerve endings and correcting hormonal imbalance. Acupuncture is very effective treatment for anovulation. Acupuncture reduces stress by regulating response to stress and altering stress related chemical substances levels; improves hypothalamus-pituitary-ovarian axis function and regulates blood hormone level. As a consequence, it improves ovulation and pregnancy rate.
Here are some clinical reports about the effectiveness of acupuncture on anovulation.
There was a control trial with acupuncture group and control group (treated with Clomephene). 25 cases in each group were given 6 cycles treatments. And then ovulation and pregnancy rate were compared between the two groups. Ovulation rate is not significantly different between the two groups. The pregnancy rate is higher (44%) in the acupuncture group than in the control group (16%).
There was a case report from a reproductive health institute center in Sichuan in China. They reported the effectiveness of acupuncture on women with anovulation. Ovulation rate was from 70-80% and pregnancy rate was from 40% - 60%.
Recently Yan and Liu summarised some case reports about effectiveness of acupuncture on increasing ovulation. They collected 21 papers which used acupuncture treated anovulation associated infertility.
Here are some typical cases.
Chen et al treated 42 patients with infertility associated with anovulation. 41 of them ovulated.
Kou et al used acupuncture treatment for 50 cases of anovulation associated infertility. 40 of 50 patients achieved pregnancy.
Chang et al used acupuncture for 32 patients with anovulation associated infertility. 9 patients achieved pregnancy during 1-3 month of acupuncture treatment. 22 patients achieved pregnancy over 4 months of acupuncture treatments.
Case report for effectiveness of acupuncture on infertility caused by anovulation
There was a study about effectiveness of acupuncture for infertility without ovulation. There were 50 women with infertility without ovulation. There women were divided into two groups: acupuncture group and control group. Control group was treated with clomiphere and injection of chorionic gonadotropin. The period of treatment was 6 cycles and ovulation rate and pregnancy rate were measured. The results showed that there was no difference in the ovulation rate between the acupuncture group and clomiphere group. However the pregnancy rate in acupuncture group was significantly higher (44%) than that for control group (16%). In addition the score of mucus and endometrial thickness was greater in acupuncture group.
This is a case report on effect of acupuncture treatment of infertility caused by ovulatory problems. 120 patients with infertility caused by ovulatory problems were divided into two groups: acupuncture group and clomiphene control group. 3 treatment cycles were applied. Result showed that similar ovulation rate was observed in both group, but pregnancy rate was higher and abortion rate was lower in acupuncture group compared to control group.
Yan and Liu Shanghai J Acu-mox, (2005) 24:40-42 (针灸促排卵临床概况)
Song FJ et al Zhongguo Zhen Jiu (2008) 28:21-23
Jiang and Ding Zhongguo Zhen Jiu (2009) 29:21-4
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Acupuncture specialist for cosmetic acupuncture, vulvodynia, other pain relief, fertility,Fatigue, neurological condition.
Based at Harley Street and Kensington Central London.Qualified as a medical doctor in Western medicine in China with a Medical degree from Beijing, China and a PhD degree from the UK. Over 25 year research and clinical experiences
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2 min walk from High Street Kensington underground stationHarley Street: for appointments at Harley Street (Wednesdays) please call ALO clinic at 02076368845 or email at email@example.comAddressSuite 3 Harmont House20 Harley Street, London W1G 9PH5 min walk from Oxford Circus underground stationMy background: I became a qualified medical doctor 25 years ago in Western medicine in China and was well trained in Western medicine together with Chinese medicine in the best Medical University in Beijing, China. Particularly I was trained with Ji-sheng Han famous professor and neuroscientist in China and with Dr Zheren Xuan--famous orthopedics expert and founder of soft tissue surgery in China. Furthermore I had training in dermatology and oral and maxilofacial surgery in China. Also I had training in fertility and had research experiences in uterine smooth muscles and blood vessels in China and the UK. I am dedicated to treat patients with acupuncture and am recognised as one of the world leading acupuncture specialists.
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Facial aging, Facial acupuncture for anti-aging
Know the ovary and acupuncture to get pregnant
Know the ovary and acupuncture to get pregnant