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Ask an expert - body - fertility

41 questions

Q: My two tubes are blocked.  I have been trying to get pregnant for more than 6 years. Do you think the Chinese medicine and acupuncture can help me?

A: We were asked this question some time ago and the answer we gave then was:

Q:  I have been diagnosed with one blocked and one partially blocked fallopian tube, will I benefit from any treatment you can offer?

A: A great deal depends on what has caused the blockage. There are dozens of first hand accounts on the internet of women who have used acupuncture and herbal medicine after being diagnosed with blocked tubes who report that the treatment has caused the tubes to unblock. There are also a couple of sites where health professionals have speculated that the diagnosis of blocked tubes is not always accurate, and that some forms of internal examination can replicate the presentation of a blocked tube which on laparoscopy turns out not to be blocked and therefore may respond to treatment.

The majority view, however, seems to be that if there is a physical reason for the blockage, such as scarring following surgery, or after Pelvic Inflammatory Disease, or after the appearance of adhesions through endometriosis or chlamydia, then the chances of reversing the damage with acupuncture or any other non-surgical modality are relatively poor.

We do not like to be discouraging, but there is little or no evidence from research trials or even from case studies written up by health professionals that a blocked fallopian tube can be sorted out, and IVF remains the only option besides microsurgery for a woman wanting to become pregnant. The chances of microsurgery offering a solution will depend on what caused the original blockage and how severe the blockage is.

We think that this remains the most realistic advice we can offer, disappointing as it may sound.

 

Q: I am presently doing IVF treatment and I am having acupuncture sessions. I would like to know if I can carry on with the sessions after the embryo transfer? Is it safe to continue acupuncture treatment after the embryo transfer and during pregnancy?

A: Generally speaking, in the hands of a properly trained and qualified acupuncturist it is perfectly safe to continue with acupuncture treatment during pregnancy. Most practitioners tend to do the least possible as maintenance treatment throughout the term, and will only see someone more frequently if a problem such as morning sickness or severe backache presents. All practitioners are trained to avoid a number of more risk-laden points at various stages of the pregnancy, but it would be fair to say that rarely do European practitioners use the same level of vigorous treatment which is common in China, and the risk would probably be minimal. However, in deference to the wisdom of 2000 years of practice all BAcC members avoid what are called 'forbidden points'.

The best person to ask for advice, though, is probably the practitioner you are seeing. He or she will be far better acquainted with your system than we could possibly be at a distance, and will be able to offer advice based on your unique balance. Many BAcC members have done additional postgraduate training in the field of obstetrics and fertility treatment, and it is one of a very small number of areas (paediatrics is another) where we have working groups looking at what defines expert practice with a view to recognising the training standards involved. It may well be that your practitioner has done this sort of training, but if he or she hasn't there are many practitioners who have who could offer expert advice based on your specific presentation.

Q:   Can acupuncture help with infertility, endometriosis, fibroid and severe abdominal pain. I live in Ghana, how do I find a specialist in this field?

A:We have to say that we are finding it very difficult to locate a reputable practitioner in Ghana. We don't mean that there aren't any, but we have no way of checking from this distance whether someone is a bona fide practitioner or not. There are a number of companies which appear to advertise themselves as having outlets all over Ghana, but the ones that we can find are mainly based in Accra. If you can locate one of these they may be able to help you to find professional colleagues elsewhere in the country. The other option is to ask your Department of Health. Acupuncture is quite often regulated by the state, and this means that there may be a nationwide listing.

As far as the conditions which you mention are concerned. we have a number of factsheets which can tell you how successful is in treating these conditions, The main ones are:

http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/female-fertility.html

http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/endometriosis.html

We have been asked a number of questions about these problems over the years, and one answer which may be of use to you was:

I have 3, 4cm Fibroids. I am also trying for a baby. Does accupuncture help to reduce the size of these fibroids and improve fertility?

From a western perspective the evidence for treating fibroids is not that good. In a major review undertaken two years ago

http://www.thecochranelibrary.com/userfiles/ccoch/file/Acupuncture_ancient_traditions/CD007221.pdf

the authors concluded that while acupuncture was heavily used in China to treat fibroids, there was not enough research conducted according to the best practice in the West to be able to draw firm conclusions. The same applies to acupuncture for the treatment of (in)fertility. As our own factsheet acknowledges such evidence as there is does not really provide a strong enough foundation to make sustainable claims.

However, one of the great strengths of Chinese medicine is that it operates with an entirely different understanding of pathology and physiology. There are ways in which conditions which are given western labels like 'fibroids' are understood which do not overlap or translate exactly with the western label. Fibroids, for example, are sometimes described as 'Blood stasis' or as manifestations of 'Dampness', and the treatment protocols are aimed at these as systemic problems which manifest in the local disturbance. If the diagnosis is one of 'blood stasis' or 'dampness' there may well be other symptoms and diagnostic signs which confirm this pattern.

As far as fertility is concerned, much the same reasoning applies. The Chinese took the simplistic, but effective, view that if everything was in balance, then natural processes should happen without problem. If a natural process like conception did not function, then it was simply a matter of correcting the overall balance and letting nature take its course. Even if there are specific symptoms which are implicated in the failure to conceive, these may still be best understood as part of an overall pattern and treated accordingly.

Our one word of caution is that the acupuncture treatment of fertility issues, especially related to assisted reproduction such as IVF and ICSI, has become a growth industry over the last few years, and alongside BAcC members many other individuals and clinics have set up which often charge extremely high fees for treatment which is no better than that offered by any BAcC member. While we do not recognise specialisms, there are many BAcC members who focus their work on fertility and pregnancy issues, and often have a wealth of additional background knowledge in these areas. For women undergoing IVF and ICSI this understanding can be a valuable addition to the work that a BAcC member does. The acupuncture treatment itself, however, is based on principles over 2000 years old which underpin the work of all BAcC members.

It is also worth using the search facility on our home page to see what other answers we have given over the years, many of which may be relevant to you.

What we have to say, though, is that the evidence for the use of acupuncture treatment of endometriosis and fibroids is not great, but that is mainly a reflection of the fact that there isn't a great deal of it in the West, and the studies from China, of which there are hundreds, are often methodologically flawed. Anecdotally we can say that we have had some success with all aspects which you touch on but we would have to be honest and say that fibroids and endometriosis, particularly the latter, can be very treatment resistant, and if they are becoming a source of secondary problems, such as infertility, there may be no other resort than surgical options.

As you can see from the embedded answer, the treatment of fertility problems has become something of a growth area in the last decade, and with it have come entrepreneurs on the fringes of the complementary health world happy to cash in on what is a highly emotionally charged situation. We would advise you to take special care if you do find people who promise results at a price. A bona fide professional will see fertility problems as just another manifestation of problems in someone's energies, and will treat the person exactly as they would if the presenting symptom were headaches or IBS.

That said, we are on the point of recognising expert practice in this field in the UK, and practitioners who have undertaken significant postgraduate training in working with this group will be able to lay claim to recognition as expert practitioners.

We wish you well in your search for a good practitioner.

Q:  Last year I had an ectopic pregnancy in my left fallopian tube and then an early miscarriage 6 months later. My left tube is now blocked but my right is open.  I had about 3 acupuncture sessions last Aug/Sept and the woman put a needle in my wrist which caused a big electric shock sensation and ever since I have had mild tingling in that arm and wrist. The thing that is worrying me terribly is that I now only ovulate from my left ovary (I know this as I get ovulation pains).  As my left fallopian is blocked however, this means I cannot conceive. 

I'm so worried that the nerve damage that was caused in my left wrist has somehow caused me also to only ovulate from my left ovary. Please can you confirm whether this may be the case and whether the pressure points in the wrist or arm correspond to ovulation. 

How can I get my body to ovulate from the right side -should I try further acupuncture sessions?  I'm so worried that the acupuncture has made me infertile. I conceived twice last year within 6 months and since the acupuncture nothing has happened.

 

A:  The most important thing to say is that there is no possibility in either conventional or traditional Chinese medicine terms that a needle placed in the wrist will have affected your ovulation in the right ovary. We are a little concerned, though, that you are still experiencing discomfort in the area, and were you to be seeing us we would by now have referred you to a GP to have a further referral on to a neurologist. In our experience, needling the area in the wrist crease can sometimes casue acute pain if the practitioner touches the median nerve, and it is also possible that deep bruising which can sometimes happen at the same time can occasionally put pressure on the nerve for a while, causing the symptoms you describe. Almost all of these problems resolve eventually, but it is always wisest to seek a referral before too much time has elapsed in case there is another intervention worth pursuing.
 
As far as ovulation is concerned, we would probably advise you to check as carefully as possible whether your right ovary is not functioning. Basal temperature checks may be a good idea, but if you have any doubts based on your normal experience of ovulation being a very palpable one, then it is very important that you have this checked by blood tests or internal examinations. You mention in your question that you conceived twice last year, which suggests that you miscarried twice as well. If so, you do need to have more formal conventional medical examinations to establish what is going on.
 
As far as further acupuncture treatment is concerned, we are sure that it will do no harm, and there are good possibilities that it may be beneficial. Although we do not have defined specialisms within acupuncture, three areas - obstetrics, paediatrics and mental health - are areas where some postgraduate training is both wise and helpful, not to increase someone's Chinese medicine knowledge as such, but to consider it more carefully in relation to the western diagnosis and treatment in these areas. If you choose to have more treatment, we would strongly recommend that you look for a practitioner who has undertaken specialist training in fertility and pregnancy. A simple google search of acupuncture, fertility and your area should elicit the names of BAcC members local to you with these skills. It wouldin our view be worthwhile asking the advice of someone face to face about the fact that you have experience changes in your ovulation pattern. 
 
 

Q:  My menstural cycle can be anything from 40-65 days and I want to try for a baby! Can acupuncture help regulate a menstural cycle?

A: The evidence from research trials for treating the problem of irregular periods is not that great, and this summary of research into menstrual problems

http://www.ncbi.nlm.nih.gov/pubmed/20483671

concludes what most of them do, that there aren't enough studies and that more needs to be done. When you consider how trials are conducted, though, this is not a surprise. Researchers like a very clean definition of what they are trying to test, and irregular periods can mean anything and also have a number of distinct causes, as for example polcystic ovary syndrome, which means that it would be difficult to draw conclusions.

Chinese Medicine, however, has an entirely different understanding of the physiology of the human body based on a view that there is a flow of energy, called 'qi', which underpins all body functions and the balance and rhythms of which make sure that all natural processes take place as they should. Irregularities of periods, or sleep patterns or bowel movements, to name three of the most common problems which we treat, often point to specific parts of the system which are out of kilter, and if these are confirmed by the kinds of diagnosis which we undertake, there is a possibility that acupuncture treatment may be of benefit.

Of course, one of the 'management' issues which we always face is that it takes a few months to establish whether or not the treatment is working, and management of the treatment is a crucial business. We do not want to overtreat, and many practitioners have developed expertise at understanding the rhythms of the menstrual cycle in Chinese medicine terms and know how to make effective interventions at just the right time without just treating away weekly for three or four months.

The best advice we can give you is to contact a BAcC member local to you for a face to face assessment fo whether acupuncture may be of benefit in your circumstances. An increasing number of our members now specialise in fertility issues, and although we have not yet recognised agreed standards for expert practice, many of our members have undertaken high quality postgraduate practice in the field. If you good acupuncture and fertility for your area you will undoubtedly generate a number of names.

We have to warn you, though, to exercise caution. Fertility treatment has become big business, and there are many people now offering acupuncture who do not necessarily belong to professional associations and whose charges can be on the high side. Our members will be able to give you advice on who best to see in your area, even if they do not have this particular area of expertise themselves

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