Acupuncture support for fertility and pregnancy

Many woman and men visit my clinics for acupuncture support with their fertility and pregnancy. Some come to try to promote their natural fertility, others come as they are experiencing problems conceiving and some come as they are preparing for IUI, IVF or ICSI. Other women access treatment when pregnant to deal with a variety of pregnancy related issues. I trained with Zita West in 2006 and Debra Betts in 2007, strengthening my experience and knowledge of fertility, pregnancy and labour issues. I have compliled this page of information which I hope will be useful to anyone who is interested in fertility issues.

Sections of this page:

How acupuncture can help

Acupuncture may help in many ways:

  • Feel calmer and more relaxed. Trying to conceive can be a stressful and despairing endeavour. Some women feel very anxious about maintaining a pregnancy and acupuncture can help mange these fears.
  • Regulate the menstrual cycle, so periods and ovulation follow a regular pattern. Menstrual cycles ideally follow a regular pattern of between 25 to 32 days. This shows that the flow of energy and blood are balanced and free-flowing enough to support pregnancy. It also helps you to plan when you are at your most fertile. Often women coming off the contraceptive pill or injection can experience disruption of their cycle and it can naturally take over a year to become more regular. Acupuncture may work to speed up this process and help you to feel the natural flow of a working cycle.
  • Improve the quality and quantity of a woman’s cervical mucous. Fertile mucous is an indicator that ovulation is about to occur and helps to nourish the sperm and guide the egg – it almost acts as a ladder for the sperm to climb.
  • Promote a healthy menstrual bleed. The period can tell us a lot about what is happening in the body with the blood, in terms of menstrual flow, fibroids, endometriosis etc. Acupuncture aims to balance this flow so a good quality and thick endometrial (uterus) lining is built, encouraging the embryo to successfully implant.
  • Enhance egg development. Women are born with their eggs and it is not possible to change the genetics of this. However, it has been suggested that acupuncture may help to increase the blood supply to the developing follicles and improve the nutritional supply to the egg with the fluids that surround and nourish it, thereby enhancing egg development.
  • Increase sperm quality and quantity. Acupuncture may help to increase the motility, morphology and volume of sperm being produced. Sperm take 3 months to form and a course of treatment, alongside a good diet, can affect sperm quality and quantity. Researchers, in the medical journal Fertility and Sterility, reported in 2005, on a study which showed an improvement in sperm quality following acupuncture, especially the structural integrity of sperm. Dr. Jian Pei, from Christian-Lauritzen-Institut in Ulm, Germany, and colleagues assessed the benefits of acupuncture therapy in 28 men with unexplained sperm abnormalities, including malformed and motionless sperm, and low numbers of sperm. A variety of standard acupuncture points throughout the body were used. Acupuncture led to a significant increase in the percentage and number of sperm without structural defects, the investigators report. Visit Infertility Health Information website for some good advice and information about optimal sperm health.
  • Reduce raised FSH levels. Follicular stimulating hormone (FSH) has to reach a certain level to signal the release of an egg for ovulation to occur. As women become older and their ovarian reserve (the number of eggs they have) declines, their level of FSH can increase. Ideal levels for FSH are under 6, 6-8 is normal, 8-10 is fair, 10-12 suggests lower than normal ovarian reserve, 12-17 indicates lower still reserves, and more than 17 generally suggests a very poor response to assisted conception techniques. However anecdotal evidence from acupuncture practitioners such as Zita West and Randine Lewis, suggests that women with high FSH levels have gone on to have successful pregnancies.
  • Encourage embryo implantation and support IVF and ICSI. Acupuncture may help to support the successful implantation of the fertilised egg. It is recommended that women having an embryo transfer receive acupuncture before and after the transfer. I usually see women on their way in and back from the clinic or hospital. This treatment also helps the woman to feel relaxed. In the research by Paulus et al, women who had received acupuncture pre and post embryo transfer had a success rate for IVF of 42.5% compared to 26.3% in the control group. These results have been duplicated with similar results in other parts of the West.
  • Reduce risk of miscarriage and increase live birth rate. I have worked successfully with a number of women who have a history of miscarriage and have come for acupuncture to try to prevent a further loss in a new pregnancy. Treatment is usually offered up to 12-14 weeks and also helps the woman manage her anxiety and stress around the pregnancy. An American study found that women who conceived through IVF who had acupuncture had a 0.8% miscarriage rate compared to 20% of women who did not have acupuncture. The live birth rate for each IVF cycle was 23% higher than in the control group. (American Society for Reproductive Medicine, Oct 2004).
  • Reduce morning sickness, nausea and vomiting. Many people are now aware of the power of the acupoint on the inner wrist which can be used to combat feelings of nausea. I offer a full, individualised treatment to combat morning sickness and strengthen your stomach and digestive system in the first trimester. Studies by Smith et al (2002) and Crowther et al (2002) conclude that acupuncture offers a promising treatment option to reduce morning sickness.
  • Alleviate symptoms in pregnancy such as headache, sciatica, pelvic or back pain and anxiety, without taking medication. Acupuncture offers a safe, drug-free route to managing pain and alleviating feelings of anxiety and panic that some mums-to-be can experience.
  • Assisting breech babies to turn. The use of moxabustion which involves the burning of a Chinese herb over an acupoint on the foot, can help babies in the breech position at 34-38 weeks turn and offers up to an 80% success rate. See Cardini et al (1998) and AJCM, (2007). This is a one-off treatment and I then advise the woman and her partner or support person how to continue this treatment at home.
  • Preparing for labour. Research suggests that receiving acupuncture weekly from 37 weeks reduces labour time from an average of 8 hours to 6.5 hours (Kubista and Kucera, 1974). It may also reduce the length of the labour. Zeisler’s research (1998) suggests treatment from 36 weeks reduced the 1st stage of labour (measured as the time between 3cm cervical dilation and complete dilation) from 6 hours to just 3 hours. Betts and Lennox (2006) found that pre-birth labour reduced inductions in first labours by 43% and in 2nd babies by 35%, and saw an overall reduction in epidural use of 31% and a 32% reduction in emergency caesarean delivery. I offer a tutorial for the mum-to-be and her birthing partner on using acupressure for labour. Various acupoints on the body can assist in managing labour and may help to dilate the cervix, move the baby into an optimal birthing position and manage pain on contractions. These points can be pressed with firm finger and hand pressure or with other implements e.g. wooden spoons, during labour. This also offers the birthing partner an active role in helping to support his or her partner to be as comfortable as possible.

A study in the United States has compared seven trials which used acupuncture to support IVF and found that having acupuncture treatment on the day of the embryo transfer could increase the chance of a positive pregnancy rate by 65%. Read the story in The Independent or the British Medical Journal.

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Some of my patients' stories

Around half of my work is helping women who are trying to conceive or going through fertility treatment. Here are a few of their stories:

Sarah

Sarah is a 41 year-old proud mum of baby Hugo, born through IVF. Read more

Sally

Sally got pregnant through IVF after three embryo transfers. Read more

Liz

Liz has had twins following fifth IVF cycle. Read more

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Problems conceiving

If you are having problems conceiving, remember - you are not the only one. It is estimated that 150,000 or one in seven couples in Yorkshire and the Humber are having difficulty conceiving. Though the majority of these couples will become pregnant naturally given time, a significant minority will not. Of 100 couples trying to conceive naturally:

  • 20 will conceive within one month
  • 70 will conceive within six months
  • 85 will conceive within a year
  • 90 will conceive within 18 months
  • 95 will conceive within two years

The National Institute for Clinical Excellence (NICE) define infertility as failing to get pregnant after two years of regular unprotected sex. Infertility is the commonest reason for women aged 20-45 to see their GP, after pregnancy itself. Here's the experience of one of my patients:

It's like a game of snakes and ladders. At the start of the cycle I try to make myself feel positive and reassure myself that this month it could happen. I eat well, try to stay relaxed. We have sex knowing it’s ‘baby-sex’ mid-cycle but still I try to inject some enthusiasm into it. All the time my hope is building, like climbing a ladder in snakes and ladders. Then, I go to the loo on day 30 of my cycle and see a small spot of blood. I sit there and feel a crushing wave of disappointment. Another month wasted. Another slide down the ladder. All the hope evaporates.

Couples trying to conceive can quickly feel isolated, despondent, frustrated, sad and confused. NHS services can seem confusing and standards of care vary enormously between establishments. Just when a couple have decided the time is right for them to raise a child, they can experience frustrating NHS waiting times and can feel that they are wasting precious time. A diagnosis of subfertily or infertility can be devastating, leaving partners feeling guilty, hurt and angry. It can put a strain on a relationship as one partner feels more responsible or is more active in trying to resolve the issue or as pressure to conceive mounts.

Some couples choose to have acupuncture before trying to conceive naturally to optimise their fertility health. Others may come once they have received a diagnosis for subfertility or infertility or are due to have IVF. Acupuncture can help to support people at all stages of the fertility process. Some of my patients who have had successful pregnancies are willing to talk to others who are thinking about whether to have acupuncture treatment – please ask if this would be useful for you.

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Support

Other ways of supporting yourself through this time can be by using support groups or accessing online support. There are links to lots of support organisations below.

A recent study of women who had not ovulated for six months or longer due to amenorrhoea showed that when offered 20 weeks of cognitive behavioural therapy to identify and resolve sources of stress in their lives, 80% of the women started to ovulate again, compared to 25% of women randomised to a no-treatment control group (reported at the 22nd annual conference of the European Society of Human Reproduction and Embryology in Prague, June 2006 and highlighted in The Journal of Chinese Medicine No 82, Oct 2006). Women interested in following this up are advised that currently waiting times to receive CBT on the NHS in Leeds stand at 12 months. However, Maria Law, Accredited Cognitive Behavioural Psychotherapist, now offers private CBT sessions on Saturdays at Wetherby Osteopaths. Contact her on 07971 529365 for more information.

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Useful Links

  • hfea.gov.uk A guide to all facilities both NHS and private offering fertility treatment. Includes statistics from 2004 of successful births so you can compare clinics. Displays latest HFEA inspection reports on fertility clinics. Offers a very clear and extensive free guide to fertility services, explaining which treatments are available, what to expect etc. Recommended.
  • britishfertilitysociety.org.uk The organisation that represents providers of assisted reproduction services.
  • bbc.co.uk/health/fertility Includes details of ‘A child of our time’ series and features video clips of procedures, details of what to expect from services and raises ethical questions concerning fertility.
  • verity-pcos.org.uk Group set up by women with polycystic ovaries. Offers free downloadable booklet on PCOS. Can pay to join group and access various booklets etc. I also have copies of these people can borrow.
  • endo.org.uk Site geared for those with endometriosis and includes details of support groups. Nearest to Leeds is Harrogate.
  • ivf-infertility.com Site written by health professionals. Includes fertility calendar and ovulation predictor.
  • carefertility.com Very busy bulletin board and chat room run by Care, one of the top private clinic providers. Recommended by patients of mine who have found it very supportive.
  • IVFconnections.com Another bulletin board with live chat room. Features pre-IVF questions that include a useful list of all the tests you will normally be asked to have pre IVF.

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Articles

My news archives have articles about fertility issues.

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Further reading and resources

This is a selection of titles which my patients or I have found useful.

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References

  • American Society for Reproductive Medicine (ASRM), Oct 2004
  • American Journal of Chinese Medicine 2007:35(1):27-33
  • Betts and Lennox. 2006. Medical Acupuncture. 2006. May; 17(3):17-20
  • Cardini et al. 1998. Journal of American Association (4) (JAMA).
  • Kubista and Kucera.1974. Geburtshilfe Perinatol. 1974;178:224-9
  • Rabl et al (2001) Wien klin wochenschr 2001; 113 (23-24):942-6
  • Smith, Crowther and Beilby (2002) Complementary Therapy Medicine. 2002. Jun; 10(2):78-83
  • Smith, Crowther and Beilby et al (2002). Birth. 2002, Mar: 29(1):1-9
  • Zeisler et al. 1998. Gynecol Obstet Invest. 1998; 46:22-5