Over the last 20+ years, there has been increased understanding of and respect for the practice of acupuncture. Acupuncture has become an accepted adjunct to Assisted Reproductive Techniques (ARTs). Traditional Chinese Medicine, of which acupuncture is just one part, is a highly sophisticated system of diagnosing and treating patients. It might sound unusual because acupuncturists use terms devised thousands of years ago but that doesn’t take away from its efficacy. Tiny pins are used to stimulate the body’s healing response, balance hormones, reduce pain and much more. In terms of IVF, an acupuncturist can help most effectively if patients seek treatment at least three months before starting the fertility drugs because this gives time to address the potential causes of infertility or sub-fertility. However, many couples choose to book in when they are about to start the protocols or around embryo transfer and everyone should be supported, whatever their choices. In addition to fertility issues there are the other symptoms a fertility patient might present with – migraines, IBS and insomnia being the most common. We can’t ignore these because Chinese Medicine sees each individual as a ‘whole’ organism and these presentations, even though they may seem unrelated, could potentially have an impact on fertility and the efficacy of any fertility treatment. For example, A patient whom I’d seen three years previously got in touch and wanted me to ‘just do the same as before’ but Chinese Medicine doesn’t work like that. The passing of time and, not least, a pregnancy and childbirth would have altered how her body responds. Acupuncturists are trained to take all these things into account and they are vital for us to provide effective treatment. At the Natural Fertility Centre, we treat men, women, same sex couples and single women. It is mainly women who come for treatment, but sperm issues can be addressed with acupuncture (no, we don’t put needles ‘there’) as well as erectile dysfunction or premature ejaculation. Men can find the IVF process stressful and they can be a better support for their partners if they are calm and feel heard. Acupuncture can be used during various stages of IVF to achieve different objectives but there are a couple – calming stress/anxiety and boosting circulation – that are overriding constants throughout the fertility drug protocols, whether that’s for ICSI (Intercytoplasmic Sperm Injection), IVF (In-vitro Fertilisation) or an FET (Frozen Embryo Transfer)/donor conception.
Acupuncture is highly successful at lowering levels of adrenaline in the body and this is a priority. If your sympathetic nervous system (aka ‘fight or flight’) is dominating, then the body will not be optimal for conception. After an acupuncture session, patients should leave the clinic feeling very content and relaxed because the parasympathetic nervous system (aka ‘calm and connect’) has been activated. This is vital for fertility as it helps blood flow properly and allows the organs to relax and respond. At initial consultation, an acupuncturist will ask: are you having a fresh cycle and is it your first or subsequent attempt(s)? How old are you and your partner and what are your lifestyle choices in terms of stress, rest, activity and diet? Is this an FET and are you using donor eggs or sperm? Is ICSI required and what is the background to that? If it is a Male Factor issue, do we need to look at DNA Fragmentation testing? Answers to these questions will help us to target the treatment to your specific requirements but there are also general protocols we use depending on where you are in your ART (Assisted Reproductive Technique).
During the ‘down regs’, aka ‘down regulation’, phase an acupuncturist will concentrate on reducing side effects of the fertility drugs. In the past, women potentially suffered in this phase, with hot flushes, headaches, mood swings and insomnia. Since AMH (Anti-Mullarian Hormone) testing was developed, IVF consultants have guidance as to the drug dosage appropriate for you, and side-effects from the down-regulators are not as severe. We use acupuncture during this time to work on any background fertility issues as much as we can, but so much depends on how long this phase is, your response to the drugs and any issues with endometrial lining (some might not be thin enough and others might be too thin). All these issues will inform what we, as acupuncturists, need to do to support you in the best way possible during this time. The focus is on balancing your body and getting you ready for the stimulation phase.
The ‘Stims’ Phase
The ‘Stims’, or ‘stimulation phase’ focuses on the ovaries and preparing for egg collection. There are specific acupuncture points over the ovaries (called ‘Palace of the Foetus’) which we can stimulate either just using the needles or with the addition of a TENS machine, depending on the results of each scan. Women respond differently to the fertility drugs and an experienced acupuncturist will know how to adapt treatment to what is going on and the potential risk of either a low response or OHSS (Ovarian Hyper Stimulation Syndrome). If there are early signs of OHSS, acupuncture can be used to reduce the risk of accumulating body fluids. Abdominal tightness can be alleviated. An acupuncturist will be alert to signs of thirst in patients and for more serious symptoms like breathlessness.
Egg collection can be the most difficult part for a woman to go through physically, depending on the quantity of eggs retrieved. Harvesting even a few eggs can result in abdominal bruising, cramping and pain. Acupuncture can be used post egg-collection to ‘calm the uterus’ and to promote healing and good circulation. By stimulating blood flow, we can speed up the healing process. This can be a very stressful time as the couple waits for news of how many eggs have fertilised or thawed and there is also an element of ‘no turning back’. For older couples where this might be the last chance, this time is fraught with emotion and tension so we focus on emotional support and lots of time to talk. For a FET (Frozen Embryo Transfer) we don’t need to stimulate the ovaries or worry about egg collection and instead use acupuncture to build up the womb lining and to promote production of progesterone closer to the time of embryo transfer.
At this stage, I recommend acupuncture before and after the procedure. Sometimes we see women the day before and the day after the ET (Embryo Transfer) and this seems to work well but we go with what you feel you can manage. The focus during this time is encouraging the body to hold onto the embryo, and keeping you calm and supported. There are particular acupuncture points which are for ‘raising energy’ and can be used for piles and prolapses as well as post embryo transfer.
The Two Week Wait
During the period of waiting, which varies in length depending on the stage of the embryo at transfer, acupuncture can be used to support your body and mind. We know that so much rests on the results of the blood tests and trained acupuncturists are experienced in helping you through euphoria or despair. Acupuncture affects mental and emotional states as well as the physical and we use the strength and subtleties of Chinese Medicine at our disposal to support you, come what may. I witness acupuncture’s effectiveness all the time in my clinic (www.thenaturalfertiltycentre.uk) but I am aware that, in terms of fertility, we also need to engage the best nutritional support to ensure optimum egg and sperm quality and a high level of nutrients in the womb lining. This allows for higher chances of your treatment having a successful outcome. With enough time, we can put a really effective eating plan in place but our patients are also advised to take a good, food-state (ie non-synthetic and as un-processed as possible) multivitamin, like our NFC Essentials (nfcessentials.com) and CoQ10, as a base,plus other supplements if they are indicated. An experienced fertility acupuncturist will be able to give you the best treatment to suit your needs as well as information, guidance and support. Check the British Acupuncture Council website (acupuncture.org.uk) for experienced fertility acupuncturists in your area.