Ask an expert - body - fertility - female fertility

28 questions

Q: I am having an IVF embryo transplant this afternoon followed by another acupuncture session. If I have one more session tomorrow is that safe or is it too much?

A:There is nothing to worry about, as far as we can see. Many of the protocols which have been devised for assisting in IVF are focused on the point of implantation, and the most well known of these, the Paulus Protocol, involves using acupuncture within twenty minutes of the implantation. It would not be at all surprising if someone had developed a protocol which extended this to a slightly longer time frame and to involve multiple sessions. The evidence base for the success of these protocols, especially the Paulus, is good, and even though the treatment is a formula and not the traditional acupuncture which we practise it is a good baseline from which to move forward. You can read the about Paulus here https://www.ncbi.nlm.nih.gov/pubmed/11937123.

As far as frequency of treatment is concerned it is not uncommon in China for someone to receive treatment daily for ten days, and because the treatment is offered in the outpatient departments of hospitals within the national health scheme it is accepted as a viable process for short term acute problems. There is no suggestion that over-treatment can be a problem. Acupuncture is a very safe treatment, and if the body has had enough it simply fails to respond any further. Excessive treatment might make someone very tired or a little whoozy, possibly even a little nauseous, but these effects would be very short lived.

In short it sounds as though you are in safe hands with someone who knows what they are doing, and we very much hope that it has the desired result.

Q: I've had three acupuncture sessions to try and improve my chances of conceiving. My acupuncturist said this was 'laying the foundations' for improving my fertility. She  recommended fortnightly treatments after that. Could you advise what she might have meant by 'laying the foundations'?

A: It is always a little difficult to be entirely sure what a practitioner was intending, but we think it is highly likely that she is simply describing the way that many of us work with conditions or patients where it would be unrealistic to expect quick fixes for their problems. In the treatment of migraines, for example, we might often treat someone for four or five sessions once a week, and then step back, depending on progress, to a number of monthly sessions and eventually maintenance treatment a few times a year.

 This reflects our overall view of what we are trying to achieve. Traditional acupuncture treats the person rather than the condition, so although each patient comes to us with presenting signs and symptoms our job is to make sense of these within the overall context of their energies and try to restore an overall balance. The challenge is that many of the patterns which people have in their energy systems have become deeply entrenched, so it is as much a matter of encouraging and retaining a change in the face of some resistance as it is of immediately reversing a pattern. In order to do this we often speak of using the first few sessions as a kind of foundation for what follows on which we can then build. One of our old teachers used to talk about watering plants - when you rescue a plant you might have to douse it two or three times but after that you would water less frequently to let nature take its course. Once the tide has turned, so to speak, then you can guide the changes as much as looking for major reversals.

 Fertility problems are particularly challenging in terms of treatment planning because the desired outcome, a pregnancy, is going to be possible only for a few days each month. Many practitioners undertake special postgraduate training to work with these issues, and great care is taken to address the different energetic needs at times of the cycle to encourage the best overall pattern. Early sessions would establish the overall pattern, and involve any major changes which a practitioner might want to encourage, and after that it would it building on this by carefully targeting what the following sessions aimed to do.

 We hope that this makes sense, and also that it reflects what the practitioner intended. We think it may have been to our detriment over the last decade or so to have become more focused on named conditions in our PR and marketing because this inevitably invites comparison with Western medicine which usually has set protocols involving specific numbers of treatments for many problems. In Chinese medicine each patient is unique and different, and the treatment of the same named condition in a dozen patients may be different in every case. Our aim is to restore balance to the whole system in the belief that this enables the body to put right whatever symptoms might have appeared as a consequence. Once you look at treatment in this way the notion of laying foundations makes a great deal more sense.

 

Q:  My husband and I have just started our first IUI (intra uterine insemination) treatment. I began injections to stimulate ovulation and have a second scan planned for 24th next week. I wondered if I should have an acupuncture treatment to hopefully help the process? And at which point in the cycle do you think would be best?

A:  There are no hard and fast rules about the use of acupuncture during IVF and IUI, although over the years a kind of consensus has emerged that weekly treatment as an overall constitutional benefit is a solid foundation for preparation for IUI, and then specific treatments just before and just after the IUI to maximise the chances of success.

There are a number of practitioners out there in what has become something of a growth industry who offer the treatments at the time of the IUI without any other treatments, i.e. are not qualified acupuncturists but have trained in a few limited techniques. This can have benefits, just as the more well-known Paulus Protocol has been shown to increase the success rate of IVF. However, much as we like to see evidence for the success of acupuncture treatment we are committed as generalists to treating people, and the use of formula points for specific issues not only goes against our collective grain but also seems to us to short change the patient. We believe that marrying some of these specific interventions to a more all-embracing constitutional approach is far better, and for that you really need to be seeing a professionally trained and qualified practitioner.

We are in the process of drawing up guidelines for areas of expert practice like obstetrics and paediatrics because we have an increasingly large number of members who spend the majority of their time working with pregnant or infertile women, or children. We intend to set standards through which they can claim to be expert practitioners and by which we can identify them from our membership when asked questions like this. At the moment, though, we cannot point you to individual practitioners, but we are absolutely certain that if you enter 'acupuncture fertility BAcC' and the area where you live you are pretty much guaranteed to find a member with a special interest in fertility issues who will be able to offer you the very best advice about what to do, and will almost certainly be able to gear that advice to your specific situation better than the sort of generic advice we offer here.

Q:  I'm considering acupuncture to compliment a round of IVF. I've never had acupuncture before. Do you have any advice when trying to choose where to go for this therapy? I'm due to start IVF injections in 2-3 weeks - have I left it too late to start acupuncture?

A:  It's never too late to start acupuncture treatment.  There are a number of ways in which acupuncture treatment can help a woman. Our fact sheet on fertility http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/female-fertility.html provides some fairly dry information about studies which show interesting results, but away from the more academic end of things there has been a very rapid growth in postgraduate training in acupuncture for obstetrics and fertility over the last decade. Two or three organisations have developed, all of which are set up by BAcC members and mostly with BAcC members on their 'books', whose members have all undertaken additional training in the way in which acupuncture can support someone in cycles of fertility treatment. This can extend from traditional acupuncture as it is undertaken anyway, treating the person rather than the condition, to syndrome acupuncture which finds energetic reasons why the course may not take and does its best to
maximise the chances through to measures like the Paulus Protocol which is a formula treatment applied at the time of the implantation which has had clinically  demonstrable successes.

We are confident that all of these approaches can help, which means that we would also be confident that any of our members should be able to provide you with help. However, if someone focuses their work on women undergoing IVF treatment the chances are that they will be more experienced in the western medical aspects of what is happening and have through training the wealth of accumulated wisdom of the teachers who have trained them.

We are not able to name the organisations - we are committed to maintaining a level playing field for all members until such time as we have agreed the appropriate standards for postgraduate claims for expertise - but typing acupuncture, fertility and your area into google will almost certainly guarantee a hit on someone who website will mention the organisations concerned.

The only reservation that we have is that we have seen some members becoming a part of clinics which specialise in this field but which also control the fee structure and often appear to charge considerably more for this kind of treatment than for 'normal' acupuncture treatment. In this expert's view, acupuncture is acupuncture, and the only reasons for charging up are for meeting the cost of overheads on expensive premises or for years of clinical expertise. There are no chargeable magic formulae for reatment that the average competent practitioner is not already aware of anyway. But that's a personal view!

We hope that you manage to find someone suitable before you start your course of injections, and are confident that you will.

Q:  I am wanting to get my navel pierced, and I have read many articles online claiming that it could block an important energy channel. I do no take everything
I read online as fact, and I am asking here to get correct information. I have had fertility issues in the past, and I do not want to do anything that could
jeopardize that, with it now being healed.

A:  We are aware that it is a commonly received wisdom that piercings interfere with the flow of energy in the major channels of the body, and a rapid google search did in fact turn up a large number of websites which in some cases had very alarmist warnings about the long term effects of piercing on the body, especially navel piercing. These warnings ranged from where it is to what the metals are, and more.

We have to say that there is no evidence of which we are aware that proves or disproves the effects being described. Our own feeling is that if the effects were directly causally related, then there would be a great deal more energetic disturbance on a regular basis. This particular practitioner has seen hundreds of people with navel piercings over the years and detected no demonstrable blockages or long term health consequences in any of them which could be attributed to a piercing.

We would have to say that it is a theoretical possibility, but that it would most likely have to add to an existing weakness or defect to have any significant impact. The same issue is often raised about ear piercings and their effect on points which are related to energy systems in auricular acupuncture, but we have never seen warnings about causing unintended treatment or causing secondary disruption.

In the end it's a matter of personal choice, and as long as the piercing is undertaken by someone who is properly trained, insured and registered to do it, we cannot see how there is a strong probability that anything will be adversely affected. However, we do have to accept that in some people there may be an energetic effect. If this is going to be significant enough to impact on major issues like fertility, for example, we would assume that there may be other signs and symptoms of imbalance, and you should just
keep an eye on anything which changes in the weeks and months after the piercing.

Not everyone in our organisation will agree with this view, but without categorical evidence that it is harmful we do not feel that we can say anything different.

 

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