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A women’s follicular development is very much influenced by the endocrine system. The hypothalamus, pituitary gland, and ovaries cooperative function greatly impacts our follicle quality, number of follicles produced, and ovulation. The hypothalamus produces GnRH (Gonadatropin-releasing hormone) to stimulate the pituitary to release FSH (follicle stimulating hormone) and LH (luteinizing hormone). In conjunction, the developing follicle produces estrogen, which signals an increase in LH production from the pituitary gland. The release of these hormones stimulates the follicle in the ovary to mature and triggers ovulation.

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Our hypothalamus, pituitary, and ovarian function can change or be interrupted in function due factors like preexisting conditions, age, toxins, and stress. However, the balance between the hypothalamus, pituitary, and ovaries can also be positively influenced to help prepare the body and reproductive organs for good quality follicular development, ovulation, implantation, and pregnancy.

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Ovarian factors are the leading cause of infertility. Some conditions linked to ovarian dysfunction include

• Polycystic Ovarian Syndrome (PCOS)

• Premature Ovarian Failure (POF)

• Diminished Ovarian Reserve

• Elevated FSH levels
   

Acupuncture, Egg Quality, & Ovarian Health​​

There is hope! Clinical research has shown in some studies that acupuncture & Chinese Medicine can successfully improve blood flow to the ovaries and uterus and have supported the physiological changes as stated below in the research. Acupuncture can help with ovarian issues through working to improve blood flow, nourish the yin and support balance in the body via the use of therapeutic combinations of acupuncture points.  ​
 

Research on Follicular Development, Ovulation, & Acupuncture​​

A recent study measured a control group of 19 women and an acupuncture group of 17 women. The control group received 50mg of oral clomiphene once per day for a total of 50 menstrual cycles. The acupuncture group received the clomiphene at the same dosage and rate plus regular acupuncture treatments. The researchers measured changes in ovulation, endometrial thickness, cervical mucus, pelvic fluid, and follicular development. The acupuncture group showed a higher rate of both ovulation and conception than the group receiving medication only.

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The researchers measured the effects of acupuncture and moxibustion on anovulatory infertility, a type of infertility caused by the lack of ovulation. Following the treatment regime, FSH, LH and E2 levels improved. In addition, the thickness of the endometrium increased and the follicle diameter increased. The higher pregnancy rates and objective testing resulted in the research team finding acupuncture and moxibustion successful in enhancing fertility for women with anovulatory infertility.

XU, Yin, and Miao ZHANG. “Efficacy observation on 40 cases of anovulatory infertility treated by acupuncture and moxibustion.” World Journal of Acupuncture-Moxibustion 23, no. 1 (2013): 40-43.​

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A total of 13 RCTs involving 787 patients were included in this meta-analysis. The review of available evidence revealed acupuncture produced a significant efficacy in decreasing follicle-stimulating hormone (FSH) levels (SMD = -1.07, 95%CI [-1.79, -0.36], p = 0.003), FSH/LH ratio (MD = -0.31, 95%CI [-0.54, -0.09], p = 0.006) and increasing anti-Müllerian hormone (AMH) levels (SMD = 0.25, 95%CI [-0.00, 0.49], p = 0.05), along with AFC (MD = 1.87, 95%CI [0.96, 2.79], p < 0.0001) compared to controls. Compared with electro-acupuncture treatment, manual acupuncture was superior in reducing FSH levels, FSH/LH ratio, and increasing AMH levels and AFC (p < 0.05). A notable association was also seen when acupuncture was combined with traditional Chinese medicine therapy for improving FSH levels, FSH/LH ratio, and AFC (p < 0.05). Besides, a high dose of acupuncture (≥10 acupoints) was more conducive to ameliorating FSH levels, FSH/LH ratio, and AFC (p < 0.05) than a low dose of acupuncture (<10 acupoints). Substantial heterogeneity existed among studies.

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Conclusion

Acupuncture may have significant clinical potential for patients with DOR in terms of improving sex hormones level and increasing AFC, although the evidence is drawn with high heterogeneity. This finding suggests that more rigorous trials conducted in diverse regions worldwide are necessary to identify the efficacy of acupuncture for patients diagnosed with DOR.

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Clinical efficacy of acupuncture for diminished ovarian reserve: a systematic review and meta-analysis of randomized controlled trials - P

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