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Ask an expert - body - fertility - female fertility

30 questions

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.

 

Q:  I am getting acupuncture for fertility reasons but I am a little worried.  My practitioner does not talk at all during the session which is probably normal. He begins with a very rough massage and then places needles in key areas. I am left to lie there for 20 mins until he returns to  the room and says you are finished now and that's it. I keep hearing how relaxing acupuncture is,  so I am now worried because my sessions seem so functional.  In saying that I am there to help me get pregnant so if it works I can live without the relaxation element. Please advise.

A: We are sorry to hear that your experience of treatment is not quite as you expected. Of course you are absolutely right - when you become pregnant the fact that the sessions were not as relaxing as you had hoped will fade into the background. As one of our old teachers once said, 'you're there to make people better, not to make friends'. That said, he was mainly warning about avoiding difficult treatments and hard questions, not about failing to make rapport -this was one of his great legacies, the need to establish a good rapport. While it is not an essential part of the treatment, many people do report going into states of deep relaxation when they are treated, and most practitioners will try to ensure that their patients find the experience enjoyable, whether because they drop into a restful and meditative state or talk about
their experiences and life in general.

Some practitioners, however, do not work in this way. It is not unknown for practitioners to work in the way you describe, and for some practitioners trained overseas this can often be the norm. Many Chinese practitioners, for example, are used to treating people in outpatient departments such as those where they initially trained, and this can involve working at great speed to move from patient to patient, with sometimes as many as 100 patients to see in a day. Working in the way you describe could simply be how they were trained.  This is not confined to Chinese practice; there are also a number of indigenous practitioners who prefer to let the needles do
the talking, and treat and leave. Indeed the majority of Chinese practitioner working in the West enjoy the greater amount of time available to build rapport and allow for relaxation.

Essentially, then, this is not abnormal, but not quite what you had hoped for. We suppose the choices are a little bit stark: carry on as is or drop this practitioner and go to another one. We would not be foolish enough to suggest you talk to the practitioner about changing the way he works. It might, though, he possible to address the fact that the massage is a little intense by asking for a more gentle version of the same; most responsible practitioners will be more than happy to adjust their treatments to suit the patient. This may help to make the treatment more relaxing.

We generally recommend that prospective patients shop around if they are in any doubt about what they are about to take on, and we always take the view that while rapport is not essential it helps to make the experience an enjoyable one. The same applies for length of treatment; if a very friendly practitioner works in 20 minute sessions that might not be as valuable to a prospective patient as treatment from someone with slightly less good rapport but who allows longer in the treatment room. People are perfectly free to change practitioners, and there is no reason for a subsequent practitioner to contact the previous one if the patient says that they should not. If you did choose to move, there would be no problem as long as you cancelled any outstanding treatments in good time.

Above all, though, we hope that the treatment works.

Q:  What is the best time in the cycle to begin acupuncture to boost fertility?

A: The prevalence of practitioners offering to assist in fertility has created a rather unwelcome myth that there are good and bad times to have treatment. From a Chinese medicine perspective, someone's fertility is a part of a much wider pattern of health and balance within the whole system, and the diagnosis made from this perspective will be about the person, not the part of the body or the time of the month. In exceptional circumstances there can be specific problems like Cold in the Womb which can be tracked back to specific events, but this is quite rare. The problems with fertility are often part of a much wider pattern, and treatment will have to be aimed at restoring balance across the system as a whole, which may take weeks or even months.

However, we would not want to write off the experience of an increasing number of our members who have undertaken postgraduate training in this area and whose focus has been on treating fertility and pregnancy for many years. Although the Chinese medicine does not set them apart, because we all use the same systems of diagnosis and treatment, their working knowledge of the problems which women experience and their experience of treating many women with fertility issues mean that they can be a great resource and help to a patient. They have seen similar problems before, and may well even have useful perspectives on what is happening from a western medical point of view - occasionally women slip through the conventional system with a fairly straightforward problem which has not been picked up. If you visit someone who focuses their work in this area, you may well benefit from their years of experience.

There are, though, no 'special points' which can be applied at specific times to make conception more likely. That said, many of us try to work in such a way that we treat near the time of ovulation to give the system the biggest boost possible, but there is no research evidence suggesting that this is any more than a construct which we use to fuel our own intention! Such research as does exist, which as our factsheet shows is not that great

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

tends to the view that the greatest help can come from treatment aimed at regularising the menstrual cycle or reducing the impact of PCOS. These, though, are usually treated systemically, i.e. for ten women presenting with irregular periods there may be ten different diagnoses and treatments in Chinese medicine depending on what is happening within their systems as a whole. In Chinese medicine every patient is unique, as is their treatment, even where there named condition is the same.

We are not able to give referrals to specific individuals or groups, but there are a number of well-established networks within the BAcC treating fertility issues with acupuncture, and a good search under 'acupuncture' 'fertility' and your area will very quickly identify those members who have undertaken postgraduate training in this field. We believe, though, that any BAcC member will be able to give you useful advice, and most importantly from your point of view, establish in a brief face to face assessment whether acupuncture is the best treatment to try to help you become pregnant.

 

Q: have PCOS and recently had a miscarriage in August after nearly 4 years of trying. I am keen to conceive again.  I have fortnightly reflexology appointments and am interested in acupuncture as I have heard positive reviews. Would this be beneficial for me to try this along with reflexology? Would this be likely to increase my chances?

A:   We have been asked about PCOS on a number of occasions, and a typical answer we have given has been:

Q. i suffer from pcos on both ovaries, i also suffer from weight issues due to this but have been told by nhs that they cannot help until my bmi is below 30. I know that i need to help myself but can accupuncture help whilst trying to concieve. Have been trying for 5 years.

A. The evidence for the treatment of fertility problems with acupuncture is a little thin, as our factsheet  shows. 

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

There are a number of studies which appear to indicate that acupuncture may help PCOS and the attendant fertility problems which it can cause, but not enough and not enough of consistently high quality for us to make any claims.

  However, traditional Chinese medicine has a very long history of treating exactly the same issues which trouble people today, and although its conceptual basis is entirely different from conventional western medicine, the symptoms which people have and the way in which they describe them haven't changed, and have been diagnosed and treated in Chinese medicine terms for centuries. There are a number of patterns or syndromes in Chinese medicine which reflect quite closely the sorts of problems which PCOS sufferers have and their problems with fertility, and a practitioner may be able to use these as the basis of a worthwhile strategy.

We have to be realistic, though, PCOS makes pregnancy difficult, whatever system of medicine you use to diagnose it. Our main concern is that you are not led into unnecessary time and expense for something which cannot help, and not diverted from conventional treatment which may ultimately be of benefit. Our members are responsible and safe practitioners, and if you visit one local to you, we hope that they are happy to see you for a short consultation, hopefully without charge, to determine whether the unique case which you represent in Chinese medicine terms is one for which they feel that treatment may offer some hope.

We think that this remains sound advice. Acupuncture treatment will certainly do no harm, and from a Chinese medicine perspective, where treatment is aimed at the person rather than the named condition from which a person suffers, there is a great deal to be said for maximising the body's function. The simple but profound belief underpinning a great deal of eastern medicine is that if everything is functioning as it should, then symptoms will disappear. However, one has to be realistic; where there has been longstanding pathological change it may be a much harder task to try to return basic functions to their normal state, and we are always very careful to make sure that we do not give patients false and unrealistic expectations of what might happen.

We also need to re-iterate what we have said in earlier answers, that something of an industry has built up around female fertility issues which, in this expert's view, have started to see practitioners charging more for their services than they would for 'ordinary' treatment. There is nothing, in my view, to justify this; acupuncture treats the person, not the condition, and there is very little additional expertise available in Chinese medicine to treat the problems with fertility which does not form a part of the basic training which all practitioners have. The only advantage of expert training in fertility problems is that it imparts greater knowledge of the western medicine involved and passes on the wisdom and experience of expert practitioners. This may warrant a small additional charge, but we have seen acupuncture being offered within some of the fertility clinics outside the traditional acupuncture 'circuit' at alarming fees.

We are confident that if you visit a BAcC member local to you for advice you will get a fair and realistic assessment of how and whether acupuncture treatment may be of benefit to you. 

 

 

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