acupuncture model

Acupuncture for fertility

The process of trying to conceive can be lengthy, intricate and emotional for many couples.

While media attention often focuses on women delaying conception until their late thirties and forties as the cause of complications with fertility, this is not the only issue at play with sub fertility. Other causes for infertility include; lifestyle factors such as being over or under weight, smoking, heavy drinking and stress. Contributing conditions include blocked fallopian tubes, endometriosis, Polycystic Ovarian Syndrome (PCOS) and compromised sperm quality.  In recent years more complex tests have been developed to assess genetic problems and immunological disorders that may interfere with potential pregnancy by preventing implantation or causing early miscarriage. However, many couples are only offered investigations after years of trying for a baby. Often these investigations are delayed and protracted and can contribute to any pre-existing stress.

The Fertile Ground of Acupuncture

For many, acupuncture offers a positive and beneficial treatment either to enhance the chances of natural conception or to support in the process of assisted conception. There have been several studies in recent years suggesting acupuncture can benefit fertility outcomes by:

  • Lowering stress hormones and regulating FSH
  • Improving blood flow to the pelvic area, ovaries and uterus
  • Reducing contractions of the uterus
  • Regulating the immune system

The research

While the West has tended not to engage with as many clinical trials on acupuncture for natural fertility, there is positive evidence to establish plausible explanations as to how acupuncture may benefit fertility (Gerhard 1992 and Stener-Victorin 2000, 2008, 2010).

Firstly, it has been shown that acupuncture regulates fertility hormones. Stress and other factors can disrupt the function of the Hypothalamic Pituitary-Ovarian Axis (HPOA), causing hormonal imbalances that can negatively impact fertility. Acupuncture has been shown to affect hormone levels by promoting the release of beta-endorphin in the brain, which affects the flow of the gonadotrophin-releasing hormone by the hypothalamus, the follicle stimulating hormone from the pituitary gland, and the oestrogen and progesterone levels from the ovary (Ng 2008, Huang 2008, Lim 2010, Stener-Victorin 2010).

Secondly, acupuncture has been shown to increase blood flow to the reproductive organs. While stress has the negative effect of constricting the ovarian arteries, acupuncture inhibits this sympathetic activity, improving blood flow to the ovaries (Stener-Victorin 2006, Lim 2010), enhancing the environment in which ovarian follicles develop. Furthermore, acupuncture also increases blood flow to the uterus (Stener-Victorin 1996, Huang 2008), improving the thickness of the endometrial lining and increasing the chances of embryo implantation.

Thirdly, evidence illustrates that acupuncture counteracts one of the most common causes of female infertility, Polycystic Ovarian Syndrome (PCOS). By reducing sympathetic nerve activity and balancing hormone levels, acupuncture has been shown to reduce the number of ovarian cysts, stimulate ovulation, enhance blastocyst implantation and regulate the menstrual cycle in women with PCOS (Stener-Victorin 2000, 2008, 2009, Zhang 2009). It may also help to control secondary effects such as obesity and anorexia (Lim 2010).

Acupuncture for IVF

While acupuncture has been shown to enhance natural fertility, it is also used successfully in the preparation for, and during IVF cycles, in order to optimise the uterine environment and enhance egg quality during treatment.

It is suggested that acupuncture treatments should start three months prior to IVF, scheduled weekly throughout the cycle up to the time of egg retrieval. However, a published study has also reported the positive effects of acupuncture on the day of embryo transfer (Acupuncture and assisted conception (Review), The Cochrane Collaboration, 2009). Informal feedback from gynecologists confirms that acupuncture has a hugely calming effect on patients, something which is vital both immediately before and after embryo transfer.

Traditionally trained acupuncturists make a diagnosis according to the principles of Chinese medicine. Those of us who have extensive experience of working with fertility issues offer an integral approach whereby we bring together our knowledge and experience both from an Eastern and Western perspective. This enables us to offer advice and suggestions about lifestyle and diet that complement the treatment and address the imbalances specific to each individual.

The holistic approach of Chinese medicine, which has treated gynecological conditions for centuries, aims to restore the balance of the body back to normal functioning in order to help, where possible, for women to conceive naturally. This move towards homeostasis can be translated in Western terms into better hormonal balance. Using the language of Qi (energy flow) and Blood, acupuncture reestablishes the proper flow of these two substances to enable the organs to function at their optimum. As acupuncturists we are thus particularly interested in the details of your menstrual cycle and other signs and symptoms, which help us to assess where particular imbalances lie; hence the importance of detailed case taking at the initial consultation. Each of the organs and their associated meridians have a physical and emotional influence and, by offering specific and targeted treatment, acupuncture has positive results on both.

We have an expert team of acupuncturists here at the clinic, and if you live outside of London take a look at our affiliated network to find someone near you, personally trained by Zita West.

what to do if IVF fails

What to do if IVF fails

 

It doesn’t matter who you are – if your IVF cycle is unsuccessful, you will undoubtedly feel that you personally have failed and will look for reasons why. Even though some women find it hard to think positively and may not expect their IVF to succeed, the realisation that it hasn’t worked still always comes as a shock.

Each of you will react in your own way and go through an array of emotions, depending on whether this is your first or subsequent attempt at IVF. It will take a while to get over the disappointment and to accept the loss, and then to move on and look ahead. You can’t compare yourself to other people and their reaction when their IVF cycle doesn’t work.

The blame game

Many women blame themselves for their IVF cycle not working and this is a huge psychological setback. They are often unable to look forward at this point or believe that motherhood is still a possibility. So many of the women I speak to say they feel they have done something wrong for it not to have worked, but they have no idea what. Understandably, the question they ask themselves is ‘Why didn’t it happen for me?’ The tyranny of the ‘shoulds’ then come into play: “I should have rested more,” “I shouldn’t have had that extra cup of tea,” “I shouldn’t have argued with my partner.” Trust me (and you know it really) these are not the reasons why an IVF cycle didn’t work.

You are likely to feel hurt, let down and betrayed. You will inevitably look for someone or something to blame. You may feel the need to lash out or punish in some way, or you may experience over-whelming feelings of jealousy that someone else’s IVF worked. Some women shut down emotionally and can’t be reached at this point. They remain silent and contain their feelings of anger, frustration and despair. So many women don’t like who they have become and feel like a shadow of their former selves.

Much of my work and the work of my team involves supporting couples who have had an unsuccessful IVF attempt. I work with them to come up with a plan, making small changes to their lifestyle, helping with their emotional well-being and relationship, or finding them a clinic that is more suitable for their needs. I also help couples to move on to other options. I sit in the consulting room day after day and hear the most tragic stories. However, I am usually able to help couples feel more optimistic because there really are things that can be done to help them achieve their goal. Sometimes it will depend on how far they want to go to achieve it.

Should you try again?

Many couples want to know if they should try again. This depends on their circumstances. Is their relationship solid? Can they afford to pay for another cycle of treatment? Are they emotionally and mentally strong enough? Some couples re-evaluate their situation and decide they simply cannot go through the possibility of another disappointment.

Some couples give themselves a cut-off point in terms of how many cycles they are going to do, but many women want to continue treatment at all costs. Women, more so than men, sometimes feel that if they throw everything at the process then it will eventually work. My inclination is that something has to change – that might be to do with mindset, nutrition or lifestyle. It might be worth seeing if there is anything that can be done to improve the sperm, considering moving to another clinic or even taking a break from the whole process. For some, it will mean moving on to egg donation, surrogacy, adoption, or moving on completely and coming to terms with childlessness.

Making a decision

To help you decide whether or not to try again, work through the following plan, adapting it to your particular needs:

  1. It is important to make an appointment back at your clinic as soon as possible, so that you can discuss the cycle, what happened, what were you happy and positive about, what were the negatives, any further tests that need to be done and what would you do differently next time.
  2. Wait at least two or three weeks before making your decision. This will give you some time to re-evaluate your emotions. Everybody reacts differently: some women want to start again right away while others can’t face another cycle and need a break. How long you leave it between cycles is up to you and the clinic treating you, but being strong emotionally, psychologically and mentally is all key to that decision.
  3. Practise ways of changing your mindset to enable you to feel positive. Daily meditation or relaxation and visualisation will help you to feel more optimistic – this is very important at this point. Get emotional help and support if you need it.
  4. Don’t punish yourself – build treats into your lives. I have said so many times that many of the couples I see put their lives on hold. They focus exclusively on IVF and forget to have fun. I sometimes think you just need a complete break from everything – eating whatever you like, drinking moderately – just to get a bit more fun back into your life.
  5. So many women say to me “I am a failure” and that is just not logical. You are not a failure as a person. Try listing your achievements and positive attributes – get you partner or a good friend to help you – to help get you back in balance.
  6. Look at areas of your lifestyle where you can make improvements.
  7. Don’t give up on sex after IVF. I have seen so many women get pregnant the month after IVF. I don’t know why, but it can and does happen.

Don’t miss out on life

Before you decide on your plan of action, get some normality back into your lives. For weeks now your lives have been a whirlwind of appointments and preparing yourself for IVF. It is easy to lose your sense of self and feel you are no longer the person you were. Many women ask me whether they can exercise again. I say, just go off and do the things you have always enjoyed, including exercise; have a drink if you want; put recent events behind you and let go before you decide what to do next.