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41 questions

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 currently receive acupuncture treatment for fertility. I experience headaches after some sessions, is this common and what is it due to?

A:  There are a number of short term adverse effects after treatment which happen frequently enough that we warn patients of their possibility. Headaches, a feeling of slight dizziness and occasionally a slightly nauseous feeling are common enough to warn patients of, and much more commonly a deep tiredness after the first one or two sessions is not uncommon.

There are a number of possible reasons for the effect, although we could never say with absolute certainty why things happen because each patient is unique and different. The energy system is a closed system, and so any treatment which improves the flow of energy can occasionally uncover slight blockages in the system which were not an issue when the flow was impaired. It's a rotten analogy, but sometimes central heating systems will function fine when used occasionally in the summer but then develop major problems when cranked up full in the winter. An experienced practitioner may well be able to tell from the tongue and pulse that there are blockages and deal with them.

It is also possible that the treatment is causing functional disturbances whose outcome is to generate a headache. There has been some very lively discussion over the years between those practitioners who argue that treating the person as a whole in a traditional fashion is enough to kickstart the system into operating normally, and those who use a much more formulaic syndrome-based approach to treatment which addresses the reproductive function. This latter approach can sometimes generate unwelcome consequences elsewhere because the internal connections within the system make other parts react and sometimes over-perform. Again, an experienced practitioner should be able to make sense of either of these situations, because if a symptom develops there is always going to be some evidence in the diagnostic signs that we use.

We have answered a similar question before and there we cautioned the person not to make the assumption that the headache was caused by the treatment even though it happened immediately after it. Sometimes there are coincidences, and we are always keen to ensure that if an unusual system kicks off that people don't waste time arguing about whether the acupuncture caused it or not while it goes untreated. In your case, however, the chances are that since it has happened a few times after sessions and then subsides it is treatment related.

The best advice that we can give is to talk to your practitioner and see what can be done to make these less intrusive and hopefully stop happening altogether.

And good luck with the fertility treatment!

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 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.


Q: I have been looking into acupuncture for fertility issues.  I have found a acupuncturist via your website but would like to confirm if all practitioners  on your list are qualified for fertility acupuncture?

A:  This is a rather interesting question! From one perspective, it would be very easy to say that there is no such thing as 'fertility acupuncture' as a separate sub-division within Traditional Chinese Medicine. There are a number of books which deal extensively with the medical issues which arise within pregnancy and trying to get pregnant, and in the UK a number of courses which bow equip people to focus more of their time on women who are trying to become pregnant or have become so. The differentiations on which diagnosis is based, however, are the same ones that everyone uses in treating any patient. There is even a school of thought which sees failure to get pregnant in the most general terms as a sign/symptom that the system as a whole is out of balance. Treating to establish balance, what we tend to term generalist treatment, is seen as the best way of dealing with the issue, and this expert has been successful on a number of occasions in helping patients become pregnant when there were no obvious signs of poor function in the system, but the whole system was slightly out of balance.

That said, the courses which people take and the specialist books do provide practitioners with a very good background in the western medicine of fertility treatment, and benefit from the experience of practitioners of great experience who have been able to distil the wisdom gained from decades of practice into a form which enables the postgraduate student to have a clear understanding of how the major differentiations within the system manifest in the more precisely defined areas of the body involved in pregnancy.

In summary, any BAcC member is adequately equipped to treat you, but there is a growing number who have undertaken postgraduate training with the three or four best known organisations or individuals, and who will be more than happy to provide references to their bona fides from these courses. These courses will have familiarised them with a great deal of the process of fertility treatment in the UK, and also with the specific manifestations of imbalance which affect the early stages of trying to get pregnant. We, of course, cannot name them, because we cannot be seen to endorse one course over others, but it takes very little internet research to establish the three front-runners. The course providers maintain searchable databases to enable members of the public to identify someone whom they have trained.

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