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Ask an expert - body - fertility - female fertility

30 questions

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:  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:  Is acupuncture useful on its own for fertility in a case of premature ovarian failure or has to be used plus IVF at the same time?

 

A:  As you can see from our factsheet, there is some evidence that acpuncture used in conjunction with conventional treatment for infertility can improve the chances of conception.  Please click here
 
 
but the evidence is limited and not always as methodologically robust as one might hope.
 
In more general terms, it is quite often said that traditional acupuncture, as a treatment which aims to restore harmony, balance and function across the whole system, can have an effect on individual systems and organs within the body, sometimes as a result of directly treating the organs or indirectly aiming to improve the flow and balance of energy in the whole system. Given the high stakes involved in fertility treatment, however, it is probably best to regard acupuncture as something to be used in conjunction with conventional treatment rather than instead of it.
 
If time is on your side, of course, you could set aside a number of months to see if acupuncture can have an effect on your ovulatory potential, but if there is no current evidence that the ovaries are still functioning this might simply be wasting time which might be better spent on alternatives which deliver a greater deal of certainty in their outcomes. 
 

Q:  I had two depo provera injections last year and the evil progesterone is very slow leaving my system. I am told it could take two years for depo provera to flush out of my system.

Could acupuncture help rid my body of the depo provera progesterone?  I have been on solpadol as well for over a year.

 

A: There is no research evidence to suggest that acupuncture can speed up the process of removal, so we have to be careful in what claims we make. It is also our understanding that the average washout period is about 10 months, and that fertility rates have returned to normal after about 18 months, so two years may be a little pessimistic.
 
There is no doubt that many people use acupuncture for helping themselves to readjust after long periods of taking prescription medicines, and the practitioner is usually very clear with the patient that the main focus of treatment is helping the system, understood from a Chinese medicine perspective, to return to full function after the stresses which have placed on it by the medicine. In some cases this process can overlap with the western understanding of organs such as the kidney and liver having a role in filtering out harmful or disruptive substances, but we would not want to make specific claims about a single medication.
 
We are a little concerned that you have been on solpadol for over a year. We are assuming that this is with the full knowledge of your GP, but if it isn't we are duty bound to point out that Solpadol can be quite subtly addictive, and advise you to check with your GP that the dose you are taking is safe to continue.
 

Q: Is  there medical evidence that acupuncture can heal varicose veins in legs and how can it help hormonal imbalance to regulate scarce periods ?

 

A:  The short answer to your first question is 'no'. There is no evidence of which we are aware which is conclusive enough to make any claims for the efficacy of acupuncture in 'healing' varicose veins. A great deal depends on the extent of the problem, however. Once there is considerable consolidation and tissue change there is nothing much short of surgery or injections to help the problem. In the developing stages, however, when the veins are starting to manifest and still change in relation to what someone does - worse for standing at work for hours, sitting still for extended periods of time - there are a number of protocols and syndromes within Chinese medicine which recognise this as a manifestation of poor function in some of the key parts of the internal system. If this is the case there will invariably be other accompanying symptoms, as well as diagnostically significant information to be gained from the tongue and pulse at the wrist, which might give a practitioner some confidence that they could offer some benefit by using acupuncture.
 
The same can be said of scarce periods, oligomenorrhea. There is less evidence of the use of acupuncture for this than for PMS or painful periods, both of which show some encouraging results, and what evidence there is tends to be of very small scale trials from which it is difficult to generalise. Again, there are a number of recognised patterns and syndromes within Chinese medicine - after all, this is not simply a modern problem - and there will other confirming information which might guide a practitioner towards a number of treatment options.
 
Taken both together, there are some very obvious connections which narrow the field of possibilities, and this is one of the great strengths of Chinese medicine, its ability to take symptoms which are treated as discrete and separate in western medicine and see them as part of an overall pattern of functional weaknesses in the body. Our advice to you will be familiar to anyone reading a number of these answers - visit a practitioner local to you to ask their advice and on the basis of a brief face to face assessment get some idea of whether they think that you might benefit from acupuncture treatment.

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