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%.
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.
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.
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.
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
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
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
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.
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.
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
Excessive hair growth (hirsuitism), usually on the face, chest, back or
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.
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.
Pain or defecation.
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
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.
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:
Vaginal dryness and discomfort during sex
Low mood or anxiety
Reduced sex drive (libido)
Problems with memory and concentration
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
Headaches and Migraines
Constipation and Haemorroids
Musculoskeletal conditions are often experienced during pregnancy, and
acupuncture is often an affective treatment:
Carpel Tunnel Syndrome
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.
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
Uterine problems (including endometriosis or fibroids)
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.
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.
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%.
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.