Acupuncture for Support with Assisted Reproduction Therapy - IVF, ICSI, IUI etc
The experiences of friends and family as well as supporting many patients coping with fertility issues mean I understand the level of distress it can involve when a successful pregnancy doesn’t happen. This is why successful treatment to improve fertility is so life changing and why I am so passionate about it.
If you are feeling uncomfortable about potentially having issues with fertility, its a normal way to feel but please remember that issues with fertility are incredibly common and are often not to do with you personally. Although the causes are not clearly understood, issues such as increased environmental toxins, modern diets, stress or pressures from modern lifestyles are all seen as being significant factors as well as any issues specific to an individual.
What Treatment Has to Offer
Acupuncture is the most frequently included complementary treatment to support IVF treatment and is integrated into many of the best fertility clinics across the world.
A study in 1992 found that conception rates with acupuncture rose to 42.5% compared to a non acupuncture control group that achieved a success rate of only 26.5%.¹ The interest generated by this research led to similar trials, which produced similar results. In 2018 the British Medical Journal published a systematic review of studies relating to Acupuncture with IVF and ICSI. In total these studies involved 1366 patients. This review found that acupuncture significantly increased the success of IVF treatment. In practical terms they concluded that Acupuncture treatment resulted one additional pregnancy for every 10 cycles of IVF performed.
There has been much less research on Acupuncture’s effect on natural fertility but Acupuncture has historically and is still used to treat menstrual cycle difficulties like pain, irregular or excessively short or long cycles and excessive emotional variation associated with the menstrual cycle. Acupuncture been shown in studies to affect blood flow to the uterus and ovaries.
The Stages of Acupuncture Treatment during IVF
I combine the ancient knowledge of Acupuncture with modern scientific insights to provide individualised treatment tailored to what is important to you, this involves Acupuncture treatment but also often involves advice about adjustments that can be made in daily life to help you support yourself outside of clinic. We work together with any additional information you may have from medical tests to understand the situation and resolve problems naturally.
Very importantly, my approach to treatment involves significant emotional support. ART treatment can involve significant stress as the medications often push your hormonal balance out, this sometimes involves significant physical symptoms and/or emotional ups and downs. Additionally, while Acupuncture increases the odds, ART success rates are low, so ART treatment often involves disappointment before success and this can be very distressing.
Providing a space full of empathy, understanding and support so you can manage the emotional ups and downs of IVF more easily is also absolutely key to how I look to support you in clinic.
STAGE 1 – ACUPUNCTURE PRIOR TO IVF
Many patients engage with acupuncture in the months running up to an IVF cycle. Very commonly IVF happens after a period of time of trying to get pregnant naturally, or with other ART methods such as Clomid or IUI. Although the research shows that Acupuncture on the day of the embryo transfer increases rates of success with IVF, most acupuncturists and their patients report that a period of treatment in preparation for an IVF cycle increases success further. During this stage we work to regulate your menstrual cycle, establish regular ovulation and optimise hormone levels. We look at each stage of your menstrual cycle and work to encourage the release of the best possible egg and the generation of the best possible implantation environment. Some IVF units are using Follicle Stimulating Hormone (FSH) levels as a criteria for accepting patients into IVF treatment, if your FSH level is too high Acupuncture can be useful in lowering it is too high.
STAGE 2 – Acupuncture During Down-Regulation(Long Protocol) OR before your period (short protocol)
During down-regulation, your menstrual cycle is ‘paused’ by using medication to inhibit the stimulation of the ovaries by the pituitary gland. This pause is so that the ovaries can be controlled with stimulation drugs. This regulation can cause your period to be delayed, lighter or to not happen. At this stage Acupuncture treatment is focused on making sure the womb lining is eliminated well; ensuring a complete clearing of the old endometrium gives the best opportunity for you to develop a fresh, healthy and thick lining with good blood flow. This is the best environment for successful embryo implantation.
Acupuncture at this stage also helps to reduce any side effects of down-regulation such as headaches, hot flushes or variable mood.
If you are are not taking any down-regulation medication and are on the short protocol, the goal of treatment is the same – to achieve the fullest clearing of the old lining to allow for the growth of the new.
STAGE 3 – During The Stimulation Phase
During this phase, follicles begin to develop in the ovaries and the womb lining starts to develop. Stimulating medications affect the ovaries. This stimulation causes ovaries to provide more mature eggs than on a natural menstrual cycle so that multiple eggs can be collected. At this stage Acupuncture is focused on optimising the quality and function of the endometrium, helping it thicken and have an optimal blood supply. Normally I will see people twice during this phase but if there are other issues such as thin lining, blood-clotting issues, or very dark or clotted menstrual flow, I may see you more.
STAGE 4 – Embryo Transfer
Acupuncture is performed both before and after the embryo transfer.
The focus of treatment is to increase blood circulation to the endometrium to increase receptivity and reduce any uterine contractions or spasms due to the transfer procedure. The timing of this is sometimes not known until very late in the day so we keep in close contact so we can arrange appointments as close as is possible around your transfer times. I do this because research strongly suggests that these treatments are time-dependent which means it should be done as soon as possible before and after. Although this can be logistically difficult, research shows that settling for treatment a day before and a day after provides no significant benefit.
At this point treatment also works to regulate stress hormones which affect implantation, and to support your emotions so that you more easily feel calm.
STAGE 5 – Before the Pregnancy test and ongoing
There is limited scientific evidence that having acupuncture during the “two week wait” after embryo transfer increases implantation rates but, particularly if you have experienced recurrent miscarriage, Acupuncture does have treatments designed to support the maintenance of pregnancy.
It is also the case that for many women and their partners this is a very stressful period. Acupuncture is very helpful for reducing Anxiety and helping people relax during this time.
Once a pregnancy is confirmed, then some women continue to have treatment as a way of keeping well during pregnancy, you can find more information about treatment during pregnancy here
Ultimately though it is your individual choice, I can provide you with guidance if you wish but at no stage is there any pressure to engage in more treatment then you feel is right for you.
Additional Training
The treatment of fertility is one of my 2 specialisms, the other being the treatment of children. As well as my years of accumulated experience and additional study since I graduated in 2012, I have also completed specialist additional training with world renowned fertility expert Jane Lyttleton, I also engage in continuing additional learning.
References
1) Paulus, et.al. Fertility and Sterility Vol: 77, No. 4, APRIL 2002 2) Manheimer E, Zhang G, Udoff L, et al. Effects of acupuncture on rates of pregnancy and live birth among women undergoing in vitro fertilisation: systematic review and meta-analysis. BMJ 2008;336(7643):545-549. 3) Anderson BJ, Haimovici F, Ginsburg ES, Schust DJ, Wayne PM, In vitro fertilization and acupuncture: clinical efficacy and mechanistic basis. Altern Ther Health Med. 2007 May-Jun;13(3):38-48
