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Fertility and IVF

There are many reasons why couples could be finding it difficult to conceive. It

may be due to a physical reason, such as Polycystic Ovary Syndrome or

Endometriosis, or it could be totally unexplained.

Fertility problems affect about 15% of couple in the UK. In fact, infertility is the

commonest reason for women aged 20-45 to see their GP, after pregnancy itself.

IVF (In Vitro Fertilization)

Acupuncture is a safe and gentle way to help with the anxiety and stress of the

IVF process and the side-effects of the drugs involved. In addition, trials have

shown that acupuncture can increase IVF success by up to 35%.

Down Regulation

During the Down Reg cycle, the woman is given drugs so the body’s normal

hormone functioning is blocked. The pituitary is down regulated starting on day

21 of her menstrual cycle to prevent it from functioning normally and causing

ovulation. She is then given a blood test to ensure her hormone levels are low

enough, and the uterine lining may also be scanned.

Up Regulation/Stimulation

The ovaries are then stimulated with further drugs to produce a large number of

eggs (follicular stimulation). Ideally 10 – 15 follicles will be produced, each

measuring 18 – 24mm in size. In addition, the endometrial lining must be at

least 8 mm to allow the egg to implant.

Egg Collection/Harvesting

The eggs are then collected via a needle inserted through the abdominal wall.

Sperm is also collected on the same day, and is introduced to the eggs in a petri

dish where it is assisted and monitored over the next 3 – 5 days.

Transfer/Implantation

At 5 days the embryo is called a blastocyst and has a greater chance of survival

after transfer than do younger embryos. Usually 1 or 2 blastocysts are

transferred gently through the cervix to the uterus (called blastocyst transfer or

BT); any more and the risk of multiple pregnancy is too great.

The success of implantation depends on the uterine lining and on the embryo

itself. If the embryo is strong and its genetic programming is good, it will very

likely succeed in implanting and continue to develop.

Acupuncture is given at these various stages:

Preparing you for IVF – regulating the cycle. In various studies it has been

suggested that acupuncture can affect hormones (such as oestrogen,

progesterone, LH. FSH, GnRH, cortisol and prolactin), by having a regulatory

effect on the hypothalamus-pituitary-ovarian-adrenal axis

Down reg and stimulation – acupuncture assists in the adverse effects of the

drugs given, but also helps to ripen the eggs and thicken the endometrial lining.

Side effects of the drugs include night sweats, thirst, hot flushes and mood

swings, abdominal bloating, discomfort, nausea, dizziness, headaches and

insomnia.

Pre and Post collection

Pre and Post Transfer (up to 24 hours, but a close to transfer as possible)

I am flexible to do pre/post transfer treatments throughout the week. I am also

part of a wider network of Acupuncturists experienced in fertility for when I am

away.

Unexplained Infertility

Even after the most exhaustive tests, over 20% of infertile couples are labelled as

having ‘unexplained infertility’ as no obvious cause can be identified.

By reestablishing balance and therefore improving a person’s overall health both

physically and mentally, acupuncture can increase the possibility of a natural

conception.

As well as physiological problems there may also be psycho-emotional aspects

blocking successful conception. Stress affects every process in the body, from

the digestive system to the reproductive system. Acupuncture can help to

reduce stress and build your vitality and general health.

Male Fertility

There has been a significant decline in sperm density in the average male from

1938 to 1990. In Europe, that decline has been about 3% per year. In 30% of the

cases of infertility, the pathology is in the man alone, and 60% of male

infertility/subfertility is unexplained.

There are many reasons why a man’s sperm may be affected. Sperm are

sensitive to heat and cold, stress or depression, as well as lifestyle irregularities,

diet, trauma, or just simply over-doing it. And contrary to popular belief, sperm

quality does decrease with age.

Women’s Health

Polycystic Ovary Syndrome (PCOS)

PCOS is a common condition that affects how a woman’s ovaries work. The cysts

are not harmful but lead to hormone imbalances. Only a blood test and scan of

your ovaries can diagnose PCOS, but the signs and symptoms are:

 Irregular periods or no periods at all.

 Difficulty getting pregnant as a result of irregular ovulation or failure to

ovulate.

 Excessive hair growth (hirsuitism), usually on the face, chest, back or

buttocks.

 Weight gain.

 Thinning hair and hair loss from the head.

 Oily skin or acne.

It is also associated with an increased risk of developing health problems in later

life, such as Type 2 Diabetes and high cholesterol levels.

Endometriosis

20-40% of women with endometriosis will not conceive naturally.

Endometriosis is a common condition where tissue that behaves like the lining of

the womb (endometrium) is found in other parts of the body. It can appear in

many different places, including the ovaries, fallopian tubes, inside the abdomen,

and in, or around, the bladder or bowel.

Endometriosis mainly affects women of childbearing age and is less common in

women who have been through the menopause.

Common symptoms include:

 Painful, heavy, or irregular periods.

 Pain during or after sex.

 Infertility.

 Pain or defecation.

 Fatigue.

Adenomyosis

Adenomyosis is a condition in which the inner lining of the uterus (the

endometrium) breaks through the muscle wall of the uterus (the myometrium).

While some women diagnosed with adenomyosis have no symptoms, the disease

can cause:

 Heavy, prolonged menstrual bleeding.

 Severe menstrual cramps.

 Abdominal pressure and bloating.

Adenomyosis is a common condition, most often diagnosed in middle-aged

women and women who have had children. Some studies also suggest that

women who have had prior uterine surgery may be at risk of adenomyosis.

Menopause

Although a natural process, some women can have some severe symptoms than

usual. Menopause is not a sudden event, but a gradual physiological process

throughout a woman’s lifetime. This means that the biological basis of the

menopause is determined by her lifestyle and dietary habits right from

childhood to the time of the cessation of menstruation. In fact, many women go

through this transition with no symptoms. But in a minority of cases, symptoms

may be very severe. Common symptoms include:

 Hot flushes

 Night sweats

 Vaginal dryness and discomfort during sex

 Difficult sleeping

 Low mood or anxiety

 Reduced sex drive (libido)

 Problems with memory and concentration

Pregnancy care

Whichever trimester you are in, acupuncture can help.

Acupuncture can be used to assist with a range of pregnancy related conditions as an alternative to taking medication.

General pregnancy care

Fatigue and exhaustion

Itching

Headaches and Migraines

Constipation and Haemorroids

Postpartum recovery

Musculoskeletal Pain

Musculoskeletal conditions are often experienced during pregnancy, and

acupuncture is often an affective treatment:

 Backache

 Sciatica

 Rib pain

 Hip pain

 Pelvic pain

 Carpel Tunnel Syndrome

Morning Sickness

If your sickness is prolonged and you are unable to eat, acupuncture can be very effective.

Morning sickness affects 50-80% of pregnant women.

Nausea and vomiting typically begins between weeks 4 and 6 of gestation.

60% of affected women are better by week 4

90% are better by week 16.

In a small number of cases it may persist through the entire pregnancy.

Habitual Miscarriage

About 30% of pregnancies end in miscarriage.

Acupuncture pre-conceptual care should include treatment to offset any

weaknesses that a woman might have that might lead to miscarriage, especially if

they have experienced one already.

Habitual miscarriage or recurrent spontaneous miscarriage (RSM) is a diagnostic

label used when three or more consecutive miscarriages have occurred.

The causes of habitual miscarriage are largely unclear but may include:

 Maldevelopment of the foetus

 Luteal phase defective

 Blood-clotting disorders

 Thyroid disorders

 Endochrine disorders

 Immunological reactions

 Anti-nuclear antibodies

 Uterine problems (including endometriosis or fibroids)

 Incomplete cervix

 Maternal disease

 Stress and anxiety

For those women who have had previous miscarriages, receiving TCM treatment

to prepare the body is just as important as treatment during pregnancy itself.

Ideally treatment should start 3 months prior to conception. If possible, a

woman should not try to get pregnant for between 6 months to one year after a

miscarriage. TCM sees a miscarriage as hugely draining and the woman’s body

needs time to recover before attempting another pregnancy.

Anxiety and Depression

Around 15% of pregnant women suffer from anxiety, and around 20% suffer

from some form of depression. Elevated distress and depression scores are

associated with more negative pregnancy outcomes, such as preterm labour,

delivery complications, low birth weight, and poor maternal-foetal attachment.

A substantial proportion of women who are depressed during pregnancy

continue to be depressed during the postpartum period, affecting not only the

mother but also the infant. Depressed pregnant women are rightly reluctant to

take antidepressant medications.

Insomnia can complicate anxiety. Reasons why women experience insomnia in

preganancy may be due to nausea or increased urination, or even a history of

insomnia pre-pregnancy. Women with persistent insomnia may have previously

been self-medicating with alcohol, herbal remedies or medication, but will of

course want to avoid these in pregnancy.

Pre-eclampsia

Pregnancy induced Hypertension (PIH) or pre-eclampsia refers to elevated blood

pressure during pregnancy. It occurs in over 5% of pregnant women in the UK.

PIH is closely monitored since if it is left untreated there is a potential for

eclampsia to develop, a serious condition with maternal convulsions and the

possibility of maternal and foetal death. However, eclampsia is now extremely

rare due to antenatal care. Women entering pregnancy with pre-existing high

blood pressure will be closely monitored.

Acupuncture can be given as a support to regular medical intervention, but not

as an alternative.

Turning a Breech

The optimum time to turn a breech with Moxabustion is around week 34, this is

before the baby has grown too large.

Nearly 50% of breech babies turn spontaneously by week 36, so midwives and

doctors often wait until week 36 before discussing options. In clinical practice it

is best to begin treatment as near to week 34 as possible, although it is still

worth trying up to week 39.

Pre-birth acupuncture

In the final weeks of pregnancy new discomforts often appear, such as

heartburn, constipation, varicose veins, leg cramps, feet and hand swelling,

insomnia, anxiety and tiredness. Women may also experience frequent urination

as the baby presses on the bladder. Research has shown that acupuncture

during this time can shorten the duration of labour in first time mothers by 25%.

Induction

If it is seen as necessary by a woman’s midwife or doctor to medically induce

labour, the use of acupuncture can be commenced three days prior to the

medical induction. The aim of the acupuncture is to help establish contractions

and promote cervical dilation. Even if labour does not commence spontaneously,

feedback from midwives suggest that a woman’s cervix is more favourable

following acupuncture/acupressure and that there is an increased chance of a

woman progressing through the induction with minimal intervention.