In Reply Ms Szmelskyj and Mr Szmelskyj question the rationale for increasing ovarian blood flow in women with PCOS, which conflicts with previous work.1 Electroacupuncture stimulation, independent of frequency, activates sympathetic nerve fibers innervating the ovaries during stimulation, an effect that is mediated via the central nervous system.2 The rationale for using low-frequency and not high-frequency electroacupuncture was because repeated low-frequency electroacupuncture treatment decreases sympathetic nerve activity and circulating testosterone and induces ovulation in women with PCOS.2
Wu X, Stener-Victorin E, Zhang H. Acupuncture for Infertility in Polycystic Ovary Syndrome—Reply. JAMA. 2017;318(15):1502. doi:10.1001/jama.2017.13394
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