Continuing our series ‘Ask Mike’ specialist practitioner Mike Berkley answers questions about the benefits of using acupuncture to address specific conditions.
What should you expect from your fertility acupuncturist during your initial evaluation?
First of all, your acupuncturist should be a specialist in infertility care. You can find a fertility acupuncture expert anywhere in the U.S. Your acupuncturist must be board certified in Chinese herbal medicine and they must prescribe ‘real’ herbs, not pills, powders or tinctures.
During your first visit you should have a complete and thorough intake and evaluation. This is where your acupuncturist will ask you a multitude of questions pertaining to every part of your life, life-style, and health. A good intake should take from between forty-five minutes to an hour depending upon the complexity of the case. I have, on occasion, done intakes which have lasted for two hours but that is rare. Your acupuncturist will then treat you. You will most probably be disrobed and appropriately draped. The acupuncturist will need access to your tummy and legs, ankles and feet. Don’t worry, its painless. You will remain on the table retaining the needles for between 20-45 minutes depending upon the experience and style of the acupuncturist. I recommend that my patients get treated twice weekly until pregnant and then, twice weekly for thirteen weeks after confirmation of pregnancy to help prevent miscarriage.
Regarding the treatment of infertility cases, what is the actual difference between Western medical approaches to resolution and traditional Chinese medicine approaches to resolution?
- Western reproductive medicine has several stages of intervention;
- Sexual intercourse with clomid or letrozole;
- IUI with clomid or letrozole
- IUI with injectable gonadotropins
- IVF with the concomitant medicinals
- Donor egg transfer
All of these protocols work and create live births. But what about the cases that don’t work? Where success is not to be found, where no matter what the couple does, they just can’t conceive. This is where the paradigm shift begins to happen.
In Western medical intervention (which I respect, admire and believe in), it is strictly a mechanical process. Get egg, fertilize with sperm and transfer embryo. But what if the sperm quality is poor or what if the female has poor egg quality? How does Western medicine intervene? Donor egg.
In traditional Chinese medicine we are, in fact, not really trying to directly facilitate conception in our patients. Our goal as traditional Chinese medicine practitioners is to treat the underlying cause of infertility vis a vis improving sperm, egg and lining quality. Or, reducing inflammation with acupuncture and herbs in the endometriosis patient (even after her laparoscopy), helping the morbidly obese patient lose weight so she doesn’t end up with gestational diabetes. We also try and prevent miscarriage by ensuring the proper hemodynamics and blood perfusion into the placenta to make certain that the developing fetus is getting the proper nourishment while maintaining the ability to safely and efficiently eliminate toxins. This is why, in my opinion, all couples who are being treated for fertility challenges should also be under the care of a reproductive acupuncturist.
Acupuncture and herbal medicine can only help.
Should a patient continue with acupuncture treatment after pregnancy is confirmed?
What are the reasons for miscarriage?
- Chromosomally abnormal embryos (aneuploidy)
- Sub chorionic hematoma;
- Inadequate endometrial lining
- Immunological disorders
- Throbmophilic disorders (clotting factors)
- Inadequate blood supply to the placenta and the developing fetus.
This last item ends in miscarriage due to IUFD or IUGR which are intra-uterine-fetal-demise or intra-uterine-growth-retardation. IUFD or IUGR are very amenable to acupuncture treatment.
Sub chorionic hematoma can also be helped with acupuncture and herbal medicine. The rest of the listed pathologies are best addressed with Western medicine. Also, I should mention that if a patient has a thin lining, is often (though not always) responsive to acupuncture. I typically treat patients twice weekly for thirteen weeks after pregnancy is confirmed as 90% of miscarriages occur by or before the 12th week of gestation. If I can get a patient to 13 weeks, she is probably going to give birth.
Is being treated with acupuncture when I’m pregnant safe?
Yes and no. There are several contraindicated acupuncture points that should not be used on a pregnant patient. In the hands of an experienced reproductive acupuncturist, it is totally safe and beneficial.
What is your opinion on the use of herbal medicine?
Herbal medicine is imperative. Acupuncture works from the outside in and herbs work from the inside out. Herbs are medicine that have very specific functions when composed properly. For example, herbs can nourish and supplement; herbs can reduce and regulate. This means that herbs can improve egg quality, lining quality (supplementation), as well as reduce testosterone, inflammation, retained blood in the uterus, (reduction). Herbs are taken twice daily and taken every day. Acupuncture is provided twice weekly. So, when taking herbal medicine, the patient is essentially getting treatment 7 days per week. Herbs have been used for millennia to help couples conceive. They are more powerful than acupuncture. Acupuncture has a greater stimulatory effect on blood and energy (stimulating blood flow to the follicles), herbs are more effective in actual receptor site function. In other words, herbs can effect biological systemic changes.
What do you think is the best courses of action for the couple faced with fertility challenges?
See a reproductive endocrinologist. Once a proper diagnosis is made, start acupuncture and herbs. Remember, “it takes a village.” The only reason not to get acupuncture when struggling with fertility challenges is if the challenges are of a physical nature. For example, a septate uterus, or congenital bilateral absence of the vas deferens, or Asherman’s syndrome, etc. Additionally, certain genetic disorders cannot and should not be treated by an acupuncturist. For example: micro-deletion of the ‘y’ chromosome causing aspermia (zero sperm in the testes)
When should a couple faced with fertility challenges stop using acupuncture?
If my patients haven’t delivered a baby within a year of treatment I’ll discharge them. Most cases take between three and six months to see a good outcome (or not). But, as long as there are things to improve (eggs, lining, sperm) then the acupuncturist should keep treating. If the patient has very low AMH and significantly elevated fsh, it may be time for donor egg. Or, if there are repeated miscarriages without throbmophilic or immunological or physical anomalies, then this is an idiopathic case where surrogacy may be explored.
Why are many men opposed to getting acupuncture treatment when they have obvious sperm anomalies?
It’s a psycho-emotional issue. Men consider sperm and the penis as a sign of manhood. If there is a scenario where the sperm is compromised, it can have the effect, on certain men, of impacting their self-esteem and ‘worth’ as a man. Many men are always “too busy” to come in for treatment because of their demanding jobs (but women with very demanding jobs are able to come in twice weekly). You can see that it’s not the job that’s keeping male patients’ away, it’s the fear. This is most unfortunate. And, to be fair, this is certainly not the case with all men.
Why don’t more reproductive doctors recommend acupuncture to their patients?
Primarily two reasons. Either they are concerned about who the patient will be thankful to; who will get the credit for success; it’s an ego issue. Or. They don’t believe in acupuncture as a legitimate paradigm of medicine. What’s interesting is that today, more than ever, there are abundant Western medical studies that attest to the efficacy of acupuncture when dealing with the infertile couple. To be fair, there are many reproductive endocrinologist who do, in fact, refer their patients to acupuncture. As I always say, ‘it takes a village!”
Is being underweight a mitigator of fertility?
Being underweight (BMI under 18.5) can reduce a woman’s fertility by causing hormone imbalances that affect ovulation and the chance of getting pregnant. Compared to women in the healthy weight range, underweight women are more likely to take more than a year to get pregnant.
Is marijuana safe to take for the couple TTC?
No. Marijuana has been shown to be detrimental to gametes (eggs and sperm)
Is alcohol safe for the couple TTC?
Yes. Drinking reasonably and ‘within normal limits is safe for couples who are trying to conceive. Once pregnant, the woman should cease drinking alcohol so as to avoid fetal-alcohol-syndrome.
Founder and Director of The Berkley Center for Reproductive Wellness, Mike Berkley is licensed and Board Certified in Acupuncture in New York State and certified in Chinese herbology by the National Certification Commission for Acupuncture and Oriental Medicine. Mike is one of Fertility Road’s Strategic Partners.