Acupuncture and IVF*
Traditional acupuncture can be of great benefit to couples going through IVF, especially if treatment is initiated a few months before the process begins.
What is interesting, though somewhat distressing, is that the patients I treat nowadays are facing a Catch-22 situation. There is a tremendous amount of information and knowledge available from the IVF clinic, from other therapists (including their acupuncturists) and from the internet which certainly helps build confidence about a successful outcome to the treatment.
However, there is the saying that “A watched kettle never boils.”
A few years after I qualified from the College of Integrated Chinese Medicine (CICM) in 1997 I went on a weekend seminar run by renowned 5-Element fertility acupuncturist Gerard Kite.
What he stressed continually was the importance of getting the couple – especially the female – to “forget” that they were attempting to get pregnant.
I was only partially convinced at the time since this seemed such an unrealistic scenario.
Fifteen years later, I know that he was right.
The reason I wrote it as “forget” is that clearly no-one is going to be able to fully dismiss from their minds the whole process. This is hard enough for a couple not going through IVF, let alone those that are.
However, if people can even go a little way to forgetting and are able to relax on a deeper level, this enables the body’s natural processes to takeover a little more and a successful outcome becomes increasingly likely.
This conundrum fits in with the whole philosophy of Chinese Medicine and Taoism:
“Strive but don’t strive.” That is, we have to try but not try too hard, or care but not care too much!
To use the analogy of the golfer (please feel free to insert your own-sporting or non- sporting example here!) it is well-known amongst those who play the sport that best results will be obtained when they stay in the present, forget about their score and get in the “flow”.
To be in this flow, called the Tao, is immensely hard, and is particularly so for the woman going through IVF as the process can be so overwhelming and stressful, with the final stress being the all-consuming outcome.
When I treat patients as individuals rather than as ‘a couple trying to conceive’ there is usually a better outcome in my experience.
5-Element acupuncture focuses on the individual; ie ten IVF patients all the same age might come in and all receive individual treatment. It is actually not important whether they are coming for fertility treatment or whether they suffer from migraines or etc.
By taking their pulses and looking at their emotional make-up, face colour and voice tone one is able to use certain points to rebalance the patient and allow those complex natural processes takeover.
I have never been comfortable with the term healer; rather an acupuncturist acts as a facilitator in re-establishing the patient’s flow of Qi and helping the body to rebalance itself.
Having said all this, it is clear that certain points and protocols before and during the IVF process are necessary, due to the fact that on the one hand, they work! and on the other, the patients going through the IVF feel confident that the acupuncturist has a deep working knowledge of the whole process.
There are 9 stages where acupuncture is involved for the best outcome.
It is worth noting here that many of the studies of the efficacy of acupuncture alongside IVF only administered the acupuncture treatment around the time of embryo transfer which is not until stage 8. Obviously this is not an ideal scenario.
Alongside each stage I shall describe the aim of the acupuncture treatment at this point.**
Stage 1 Follicular Development (6 months prior to egg retrieval)
Acupuncture improves utero-ovarian blood supply so treatment 6 months prior to embryo transfer may potentially influence follicular development.***
Stage 2 Sperm (3 months prior to sperm collection)
If acupuncture can be beneficial to the process of spermatogenesis (it’s still not clear from research), then such an effect can only be achieved by treating men during the 3 months before the sperm collection.
Stage 3 Recruitment of Follicles (late luteal/early follicular phase).
Acupuncture at this stage may influence follicular recruitment, resulting in a greater pool of follicles available for stimulation.
Stage 4 Endometrial Lining (stimulation phase)
To influence the development of the endometrium there need to be regular acupuncture treatments at this point.
Stage 5 Follicular Response to Gonadotrophin stimulation
As acupuncture can improve utero-ovarian blood supply, this can have a positive effect on recovering a mature egg, higher-grade embryos and thus an improved chance of pregnancy. This is because studies show that follicular development is directly related to blood supply.
Stage 6 Final Follicular and Egg Maturation (between ovulation trigger and egg retrieval)
Acupuncture treatment on the day between the trigger injection and egg retrieval appears to have a very beneficial effect on egg maturation.
Stage 7 Pain Relief During Egg Retrieval (optional)
Whilst acupuncture is effective for pain relief during the procedure, there is no evidence to suggest that it affects conception rates if given on egg retrieval day.
Stage 8 Embryo Transfer (2, 3, or 5 days after transfer)
Acupuncture at this stage is most beneficial by reducing uterine contractions and reducing stress levels. There is also a possibility that acupuncture can modulate a woman’s immune response to the embryo.
Stage 9 Implantation and Endometrial Receptivity (days 4-8 post egg retrieval).
Acupuncture at this stage can influence implantation by improving blood supply to the uterus and reducing stress levels.****
Some patients can find this reassuring that acupuncture is heavily involved at many stages, whilst other patients, who are often already overloaded with information, simply do not want to know so much.
As an experienced acupuncturist, an essential part of my role is to gauge where the patient is at in mental, physical and emotional terms and then assess which type of treatment is most suitable.
Alongside this more “proactive” style of acupuncture, known as TCM (Traditional Chinese Medicine), the 5-Element style, as mentioned above, looks at the individual; in particular their deeper, vital health with a view to treating the Spirit- something that has a long history in Chinese Medicine.
In conclusion, it is fair to say that in my experience the combination of 5-Element and TCM acupuncture has much to offer to patients going through the IVF process.
* IVF here includes all ARTs (Assisted Reproductive Techniques).
** Please note that there is never a too rigid schedule of acupuncture for the patient, rather a flexibility to suit them during what is an intense time.
*** For more detail on folliculogenesis and acupuncture see blog.
**** Fore more detail on implantation and acupuncture see blog.