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Ask an expert - body - fertility

41 questions

Q:  can you tell me if accupuncture can help with infertility? i have one blocked tube & havent ovulated since had my son 5 years ago.
any advice would be great.   thank you

 

A: This is a far from straightforward question to answer. As far as research is concerned there is very little of sufficient quality to be able to make any encouraging noises about what acupuncture might achieve. Our factsheetis very clear on this point.
 
http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/female-fertility.html
  
That said, the fact that you haven't ovulated for the last five years is precisely the kind of reason why many women start to look at therapies like acupuncture which have an entirely different understanding of the physiology and pathology of the body. Chinese medicine is based on theories of energy, called 'qi', and its patterns of flow within the body. Within the paradigm of Chinese medicine most problems are ascribed to either blockages or disturbances in this flow which in turn lead to functional disturbances in organs and the natural rhythms of the body. Modern problems are not new, and the Chinese medicine practitioners two thousand years ago confronted the same difficulties and found ways of explaining them within their system of medicine. This also meant that they had potential solutions, and there are several distinct ways in which fertility problems are described and treated.
 
The caution in modern times is that the fertility industry has become a big business, and there are now many people offering acupuncture treatment as a part of their package for helping women with problems who are not necessarily using the sophisticated system of Chinese medicine as it was intended. Formula treatments are rarely going to be enough to deal with complex issues, and the strength of Chinese medicine lies in the skill and artistry of the practitioner in discerning the unique patterns of the individual's disease.
 
Our advice is always to visit a BAcC member local to you for a face to face assessment of whether they think acupuncture can help. We are in the process of developing systems for accrediting postgraduate training in this field so that members can make it known that they are experts in the field, but since this work is still being finalised we cannot give referrals to individual practitioners with special expertise in this field. Most BAcC members who spend a great deal of their time working with fertility issues are very clear about this on their websites, and it should be relatively simple to identify a BAcC member near you with this particular focus in their practice.  
  



Q:  I was wondering if you might be able to help. I have blocked fallopian tubes from several abdominal operations, including removal of my colon. This has left me infertile. Whilst I am losing weight pre IVF I undertook some chinese acupuncture. It involved having needles placed in the arms, neck and many in my stomach. A heat lamp was placed over me. Then a very depp and painful massage was done on the stomach and spine. This was incredibly painful and has left me very tender and with large bruises. I am now really anxious that this treatment might have caused some internal damage to my ovaries, fallopian tubes. I feel so guilty that I may have made my situation even worse and feel very distressed. The clinic wanted a course of 6 treatments all paid in advance. Do you know if any damage to this area can be done by this extreme form of deep massage? Any knowledge would extremely appreciated. I have just left a message with the assisted conception unit at  the hospital asking for their advice.  Any advice would be great please. Am getting myself in a complete tis!

 

A:  Based on what you have told us we doubt that deep massage as you describe it could do any damage to your internal organs. We are not entirely sure what the practitioner would have been doing, because although tui na, a form of massage based on the same underlying Chinese medicine principles, is practised by many BAcC members, it is rarely painful and generally does what western massage frequently does, puts people into a deep state of relaxation. However, acupuncture and tui na when practised in China tends to be a little more vigorous than that practised in the West, and your practitioner, if he ir she is a native Chinese person, may be surprised that you would find what he or she was doing in any way troubling.
 
Whilst we do not advertise individual members who focus their work on specific groups of patients, such as children or women with fertility or obstetric issues, there has been a growing trend over the last decade for BAcC members to undertake postgraduate training in working with specific groups of patients to the extent that we are now considering how to acknowledge this expertise while maintaining our core belief that all our members are properly equipped to treat any patient. In the interim, it will not be difficult to track down via google a BAcC member local to you who deals with fertility issues and to contact them for a brief chat about your experience and your current IVF programme. We are sure that they will be able to reassure you perhaps better than we can with a written reply.
 
We suspect from your description of what you have experienced, along with being 'required' to pay for six sessions up front, that you may have visited a high street shop where such practice is relatively normal. It is possible that you can discuss the problems you have had with the practitioner there, although our experience has not been entirely satisfactory when we have advised members of the public to go back and discuss issues like this. However, it is wrong to generalise in this way, and you may well find that the practitioner will adjust the treatment to be more comfortable and less disturbing to you.       
 

Q:  My husband and I are undergoing ICSI and are keen to look at acupuncture to help. How do we find the best practitioner for us, when so many offer a range of treatments? Are there real specialists in this field? We are based in London and there seem to be acupuncturists on most streets.

 

A:  Our party line, and we stand by it, is that all of our members are trained well enough to provide exemplary care to any prospective patient, whatever their problem. Chinese medicine is based on an entirely different conceptual framework from conventional western medicine, and there are no reservoirs of specialist knowledge which a postgraduate programme could tap into. Further study simply means going deeper into the core principles and concepts through the literature.
 
However, working in a western medical context does mean that some of our members focus their work on particular groups of patients, and three areas which have become the subject of intense discussion wiothin the profession are paediatrics, obstetrics and mental health. In each of these areas there are people who offer postgraduate training intended to equip practitioners better for working with the target groups. The debate we are having centres on what counts as  expert practice, and whether we can agree standards which will enable someone to claim 'expert' status. We have some way to go!
 
In the meantime, however, there are a number of networks within the BAcC which have arisen around obstetrics, and while we cannot give recommendations, we would say that anyone who has taken the time and trouble to meet the criteria for joining these networks is probably spending more time with women who are either trying to become pregnant or who have become pregnant, and are more likely to have come across the problems with treatment than the average practitioner who may see a smaller number of patients in this group in their normal list. Visiting the websites of these networks should reveal members close to you who offer this service, or using the BAcC list of members in your area and visiting websites should quickly establish a contact or two.

Q:  Please can you advise whether acupuncture can be used alongside the fertility drug clomide? And whether there is any evidence to suggest it assists when trying to concieve whilst taking clomide?

 

A:  As our fact sheet shows please click here


there is a growing body of evidence suggesting that acupuncture treatment may play a part in helping couples with fertility issues. Many BAcC members have now undertaken extensive postgraduate training in this area, and focus their attention on working almost exclusively with women with fertility problems and pregnant women from conception through to birth. This is an area of work where the BAcC is reviewing the standards of postgraduate training to assess whether it will be happy for peoplem to claim 'expert' status in their clinic advertising.
 
As far as specific research is concerned, there is very little which suggests that the use of acupuncture alongside clomid will improve your chances of ovulation. There is a single Chinese study published earlier this year which suggest that there is a positive benefit, a measurable increase in the success rate of the two combined, but we have been unable to obtain an English language version to assess how robust rthe study was. There was also a study in Northern California which recruited patients to a trial aimed at addressing this question, but this has not yet been published.
 
What we can say, however, is that there is no harm in combining the two forms of treatment. This is an 'apples and oranges' comparison really, because although acupuncture is always spoken of as 'for this' or 'for that', in reality the signs of symptoms of disease are understood in entirely different ways in Chinese medicine from their western interpretation. Moreover, the use of acupuncture is aimed at balancing and restoring energies, not having direct targets as a western drug might have. When combined treatmensts are measured against single ones it is an open question whether the two work together or whether the improvement gained by using acupuncture may be wholly attributable to the acupuncture treatment.
 
There are, as we said, a growing number of practitioners in the BAcC with considerable expertise in this field. Although we are not yet in a position to give individual recommendations, most of those who have undertaken postgraduate training make this clearly known on their websites, and we have no doubt that a quick google search for the area where you live will produce a shortlist of BAcC members whose expertise in this field may be of use to you.  

 

Q:  I am 69 years in good health, I would like to find out if acupuncture will help me havE a stonger erection

 

A:  We are assuming that your question is about making good a slight loss of normal function (erectile dysfunction/ED) rather than whether acupuncture can be used as a sexual enhancement technique. There are a number of small studies, two of which you can find here 
 
http://www.ncbi.nlm.nih.gov/pubmed/14562135
 
http://www.ncbi.nlm.nih.gov/pubmed/10098953
 
which give some encouragement to the possibility that acupuncture in conjunction with conventional strategies can help men suffering from ED. However, the studies are small and far from conclusive, so we couldn't give a definite and positive recommendation.
 
As a general comment we would say that there are many reasons why men can begin to suffer from ED. These can range from the simple fact of ageing and the effects of conditions which become more apparent in older age, like mature onset diabetes, or to the problems associated with excessive drinking or smoking, through to the kinds of complex psychological issues which have arisen as a consequence of someone's life experience. Whether acupuncture can offer any help depends a great deal on the background against which the problem has arisen.
 
Traditional Chinese acupuncture is primarily concerned with the restoration of balance and flow in the energy of the body, and there are several distinct patterns of disease, or 'syndromes', in which poor flow or blockage of energy ('qi' as it is called in Chinese medicine) can cause erectile problems. If this were to be the case, and there were other confirming factors pointing to a specific syndrome in the overall diagnosis, there may be some possibility that acupuncture could provide some help. However, if the cause of the ED lies in a pathological condition which means that there has been some permanent loss or weakening of blood supply to the sexual organs, then acupuncture would be less likely to have any effect.
 
Our only advice to you can be to seek the view of a BAcC member local to you and discuss the matter face to face, perhaps offering them a little more background information on which they can give you a clearer assessment of whether they think acupuncture treatment may be of benefit.    
 

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