Inflammation is a basic reaction that our body responds to infection, irritation or other injury. Inflammation is a complex biological response of vascular tissue to harmful stimuli. Without inflammation, wound and infection would never heal. Inflammation is a defence and has two aspects of effects: beneficial and harmful. If our body suffered from infection or injury, the defence system tend to remove harmful stimuli, initiating healing process for repair and regeneration. This is beneficial effect. The process of acute inflammation is initiated by local blood vessels with related chemicals accumulated into tissue. Increased blood flow causes characteristic swelling, redness and heat. As a consequence, vasodilation and increased permeability cause slowing of blood flow. Inflammation could damage organs and their function if the inflammation is too strong which is harmful. Inflammation has a significant role in gynecology and infertility, affecting the ovary, uterus as well as the embryo and implantation.
Inflammation is present in women’s reproductive system physiology. There is temporary changes reflected inflammation process observed in ovary during follicular development, ovulation and luteal formation. Immune cells accumulate in the inner lining of uterus during the secretary phase of the menstrual cycle indicating inflammation involved in the endometrial cycles in uterus. Recent research found that a special protein which can inhibits immune cell function and has local anti-inflammatory effect prevented immune attack to embryo and created a local hospitable environment in uterus in early pregnancy without compromising maternal system immune function. Inflammation plays an important role in implantation as well.
Inflammation is involved in infertility. There are two major types of problems that account for most of women’s infertility: anatomic abnormality and ovulatory problems. Most anatomic abnormalities such as tube blockage that cause infertility are acquired. Infection, inflammation, ischemia and surgical injury may be the causes. Anatomic abnormalities may be asymptomatic or may be presenting pelvic pain, pelvic adhesions and infertility. Inflammation causes tissue damage and distortion. The most significant cause of inflammatory infertility is Chlamydia trachomatis infection that may result in infertility in 10-30% of infertile couples in developed countries. Inflammation causes ovulatory abnormalities. Premature ovarian failure (POF) is a typical example of the relationship between ovulatory infertility and inflammation. The incidence of POF is 1% of women under the age of 40. About 50% of POF cases have attributed to immune problems which are involved in inflammation. Antiovarian antibodies have been found in some of these cases and accumulation of immune cells in ovaries has been noted as well. Women with endometriosis are also responding to inflammation differently from those women without endometriosis. There are increased immune cells and antibodies against inner lining of uterus.
Acupuncture reduces inflammation to improve fertility. Inflammation is present in infertility. This was noted in ancient Chinese Medicine. The phenomena were explained that dampness and heat accumulate and blood stagnates in pelvis. This blocks meridian and stops energy flow causing infertility. Acupuncture treating infertility has a long history, but the effect of acupuncture is doubted because it relies on concept of changing the flow of energy on meridian which is not accepted by evidence based medicine. Recently researchers provided evidence that needles insertion into the skin and deeper tissues results in a particular pattern of afferent activity in peripheral nerves. This improves blood circulation of ovaries and uterus etc. As a result it reduces local inflammation and improves infertility.
In men, infection and inflammation of the reproductive tract including testes are widely accepted as important factors of male infertility. Inflammation is associated with disruption of testicular function leading to low sperm count and low quality of sperms. Acupuncture improves sperm count and quality of sperms. This is because acupuncture increased blood supply of testicular artery and acupuncture stimulated immune response and reduced inflammation.
Weiss G et al Reprod Sci (2009) 16: 216-229