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30 questions

Q:  i am 43 years old and have no children, although i have fell pregnant naturally while i was in my 20's, but didn't go full term. i'm a new relationship and would love to have children. am i too late, and if not, can acupuncture help me?


A: We are sorry to say that there are far too many imponderables to be able to say whether or not you could become pregnant. There are certainly a large number of women who have their first children after the age of 40, and some of the more famous have written extensively on this. However, each individual is very different, and there are all manner of factors, both from an eastern as well as western perspective, which may have a bearing on whether it would be possible to conceive. The statistics are not necessarily in your favour, with first pregnancies after 40 quite a great deal rarer, but these are just averages, not determinants of any individual case.
What we can say is that a relatively large number of BAcC members undertake specialist postgraduate training in the area of fertility and pregnancy, and there are a number of well-established protocols for dealing with some of the more common problems associated with fertility. The Chinese medicine practitioner also has the advantage of assessing the whole system, not simply looking at fertility as an independent issue, and can make use of this understanding to address some of the wider issues in someone's overall balance which may have an impact on their ability to conceive.
We cannot give individual referrals; the BAcC stands by the generalist principle that all its members can treat any patient within their own personal scope of practice. However, we are working on what would count as the standards for being able to claim to be an expert practitioner in a number of fields such as paediatrics, and fertility and the treatment of the pregnant woman. Some of the groups who have contributed this process have a considerable membership as special interest groups within the BAcC, and we take the view that it is acceptable to mention the two largest of these (the Acupuncture Fertility Network and the Zita West network) as organisations with lists of named practitioners by region through whom you may be able to obtain the specialist advice you need.
You might also find it helpful to contact BAcC members local to you to ask their advice as well. Many treat women trying to become pregnant by relying on the rather straightforward principle that if a system is functioning as it should, most natural processes unfold without further ado, and anecdotally we hear many stories of straightforward treatment according to basic principles having a successful outcome.

Q:  I have been having acupuncture to help with my fertility as we had bern trying for 2 and 1/2 years and fell pregnant after 3 sessions. My energy was very low and increased after the first 3 sessions I took Chinese herbs too. Having fallen pregnant I have carried on with acupuncture. I am 11 weeks and was told by my acupuncturist that my pulse isn't as strong as she would like it to be. Just s but anxious as to what this means? Am now taking more herbs to help.


A: When you spend your whole time practising Chinese medicine it is easy to forget sometimes that the people to whom you are talking, which is most often patients, are not quite so well trained or savvy as you are. Pulse taking is a subjective as well as objective art and skill, and most practitioners have in mind a sense of what a good strong pulse will be for each individual. This will differ greatly for an 80-year old granny and a teenage athlete, and the practitioner will often find on taking on a patient that the whole system is a bit run down and needs to be brought back to the best possible balance and health.
We suspect that all your practitioner is saying is that after the years of trying for a child and while adjusting to the early stages of pregnancy your energy has probably dipped a little, and she believes that her role is to ensure that it is as strong as possible for a successful and happy pregnancy. The strains of modern life mean that the majority of people, including sometimes ourselves, are not as well-balanced as we could be, and this means our pulses are probably not as strong as our practitioners would like. There is nothing to worry about in this. If the practitioner had serious concerns about anything, as a responsible professional she would already have raised these with you and referred you to your doctor.
One small note of concern, though, is that you said you are taking more herbs to help. We weren't quite sure whether this was at the practitioner's suggestion or whether you were increasing your own dose because you were worried that you needed boosting. If it is the latter it would be a good idea to check with your practitioner if this is OK.   

Q:  My wife has been seeing an acupuncturist for fertility issues. The acupuncturist still has not used needles on my wife after four visits. She has been using a handheld electronic device with a pointed end that doesn't break the skin (like a TENS machine). Is this treatment likely to be effective, we have our concerns as we have not heard of acupuncturists using this type of equipment in a clinic. My wife has no problem with needles and if these are more likely to be effective we would rather that these be used.


A:The use of electro-acupuncture machines, of which we assume this is one, is quite common, and there are a number of BAcC members who like to use them on a regular basis. The reason most often given by those who do so it that the EA machine can often deliver a gentle stimulation of the acupuncture point over a long period of time, and for some kinds of treatment this can be very beneficial. The majority of EA machines are wired up to needles which have been inserted as normal, although there are a few hand-held machines which can deliver the pulse waves which stimulate the energy.
There is no evidence suggesting that EA devices are any more or any less effective than traditional needling, and we assume that the practitioner would have trained with the use of needles and used this technique after deliberation and on the basis that it actually works. Most practitioners often experiment with all sorts of sizes of needle and styles of treatment until they find a system that works best for them, and we assume that this practitioner has decided on the basis of her experience of working in this field that this is her preferred and most effective option.
If your wife would prefer traditional needling, and for many people this is part of the authentic experience of acupuncture which they seek, we are sure that the practitioner will be happy to accede to this request, or at very least explain her own rationale for using the EA device instead.



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 here shows. 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.

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


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.

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