Fertility & Hormone Acupuncture
FERTILITY WITH TRADITIONAL CHINESE MEDICINE (TCM)
We believe in quality, not quantity.
Everyone's fertility is unique. There are multiple different patterns that can show up in ones cycle to show an imbalance. A great way to demonstrate this is with the Basal Body Temperature Chart (BBT). This is the act of taking your temperature first thing in the morning before movement at the same time everyday and charting it. A woman's basal body temperature will rise after she has ovulated and begins to produce progesterone. The cervix changes position throughout the cycle as well as discharge will change for optimal fertility. A BBT chart is a great tool to use to observe the cycle for pinpointing subtle nuances with a TCM practitioner, as well as for conception purposes.
A Traditional Chinese Medicine View
When treating fertility the cycle is broken down into four main stages. The menstrual phase, the follicular phase, ovulation and the luteal phase. In Western medicine there is a delicate balance of hormones flowing throughout these phases, in Traditional Chinese Medicine (TCM) there is a flow of balance with the yin and yang. Although Eastern and Western medicine don't always translate directly with each other, the hormones and differentiations are easily analyzed and categorized to fit a TCM pattern.
Menstrual Phase
During the menstrual phase your body is releasing your old lining and hormones are beginning a new cycle, the first day of bleeding is deemed as Day 1. Here we can asses how thick your lining is building depending on the bleeds length and volume. In Traditional Chinese Medicine at this time we treat to encourage the complete discharge of the menstrual blood so there is no tissue left behind. This is optimal for a new lining to grow.
Follicular Phase
Next, focus is on the follicular phase of the cycle. In terms of nourishing fertile potential, this is the most important phase. This is when the the follicular stimulating hormone (FSH) is secreted, and follicles are developing to produce an egg. Oestrogen levels are growing as the follicles develop and the lining is starting to build and prepare for implantation. The Kidneys in Chinese Medicine are very important for fertility. They store the pre-natal Qi our genetics, they store our essence and govern reproduction. TCM breaks the reproductive process into 2 basic components, Kidney yin, and Kidney yang. The yin very much so mimics Western Oestrogen where as the yang mimics Progesterone. The follicular phase is dominated by Kidney Yin, Acupuncture and herbal treatments given at this time are to ensure follicular development for quality eggs, as well as to nourish and build the uterine lining. Depending on what is going on with each individual, there can be fluctuations in the follicular development, some developing too quickly having a short follicular phase, while others take too long showing a long follicular phase. These variations with the cycle are not ideal for fertility and can be regulated with Acupuncture and Herbal treatments.
Ovulation
Once there is a dominant follicle, Oestrogen levels will be high and will trigger the release of the Luteinising hormone (LH). This hormone causes the last little maturation of the dominant follicle and then an egg is released. LH is the hormone an Ovulation Predictor Kit (OPK) is testing for. Western Medicine offers a variety of medications to treat problems with Ovulation. Clomid to encourage follicular growth, Metformin to try to regulate the cycle, HCG to induce ovulation, or Prometrium to induce menstruation, all with potential negative side effects. So far there are no Western Medical treatments effective to encourage implantation. TCM views ovulation and implantation as a very important part of the cycle. The Yin is transforming into Yang and it is imperative the the Qi in the body flow smoothly and the mind be calm. The two main organs to be nourished at this time are the Heart which dominates the mind, and the Liver to ensure the free flow of Qi within the body. TCM has been found to help regulate all different patterns associated with infertility, with no negative side effects. People can present with infertility of unknown cause. As according to Western medicine, everything checks out normal for both partners. This is where TCM is beneficial, it can pinpoint subtle imbalances to make a diagnosis, potentially with a disharmony around Ovulation and implantation.
Luteal Phase
After the egg is released, what is left behind forms the corpus luteum. This breaks down and produces Progesterone which is the dominating hormone during this phase of the cycle. In TCM we believe it is the Kidney Yang that dominates this part of the cycle. It is important to have a stable Luteal phase to support a pregnancy. If this phase is too short, often pregnancy will not occur and if the Yang is too weak a pregnancy can result in miscarriage.Treatments with TCM in this phase are to support the Kidney Yang as well as potential early pregnancy. For a more detailed description of early pregnancy treatment please reference Miscarriage.
Commonly Treated Disorders
• Menstrual Irregularities • Polycystic Ovarian Syndrome (PCOS) • Endometriosis
• Amenorrhoea, the absence of menstruation • Dysmenorrhoea, painful menstruation
• Premature Ovarian Failure (POF) • Poor Follicular Quality • Oestrogen imbalance
• Progesterone imbalance • Male factor Infertility, Sperm Issues • Miscarriage
MISCARRIAGE
There are a few physiological patterns that can happen in the body to cause a miscarriage. Although people don't often talk about it, it is very common. Sadly, there is not a lot of support out there for women unless you have had 3 miscarriages and even after that the support is fairly minimal. Traditional Chinese Medicine is a safe and effective alternative to support you and your body.
A Chinese Medicine View of Miscarriage
There are two more common differentiations found with miscarriages in Traditional Chinese Medicine. One being that once the sperm and the egg fertilize to form an embryo the cells begin to divide and for some reason they become abnormal, the body recognizes this and releases it. This in Chinese medicine we view as a follicular pattern, Kidney essence deficiency and will want to treat you prior to conceiving to help nourish your body to produce quality follicles. The second differentiation being a deficiency in Kidney yang where the body could not maintain the pregnancy but the embryo was normal. Often this is seen with a short luteal phase, low progesterone values or spotting after ovulation and before menstruation. Treating this pattern, often you'll be seen and supported with Acupuncture for the entire first trimester.
Treating Miscarriage with Traditional Chinese Medicine
Upon your first visit a thorough intake with be done to asses what is out of balance and can be treated within your body. After a differentiation has been made, a treatment plan will be given. For some women it will be recommended to do weekly visits until conception, others will be advised to come once they have conceived until they are 12 weeks, and some will be encouraged to do both.
In practice I have seen astounding results. Ranging from women with one miscarriage, normal cycles and no known reason as to why they had a loss, to women with multiple miscarriages presenting with the exact same pattern over a span of years, where western treatment had nothing left to offer them. In a multitude of patterns with Acupuncture and herbal treatments many women go on to have uncomplicated healthy pregnancies and healthy babies.
Alongside helping to maintain pregnancy during the first trimester, Acupuncture is a wonderful tool to help relieve some of the common pregnancy induced symptoms such as:
• nausea / vomiting • fatigue • constipation • insomnia
• headaches • congestion • heart burn • muscle pain
INTRA UTERINE INSEMINATION (IUI) & IN VITRO FERTILIZATION (IVF)
Always with Traditional Chinese Medicine a diagnosis will be made specific to the individual. Two people with the same Western diagnosis, do not always share the same TCM pattern and will be treated individually. It is always recommended to see a professional and get assessed as to what it going on particularly with you and your cycle. With that said, there have been many trials and studies performed on the benefits of Acupuncture and Assisted Reproductive Technology (ART). It has been proven time and again to the benefits of receiving Acupuncture treatment with specifically designed protocols during IUI and IVF sessions. A study published in one of the most prestigious medical journals in reproductive medicine demonstrated that women undergoing Acupuncture treatments had an increase in ongoing pregnancy rates of over 60%, compared to control subjects who did not receive Acupuncture.
When To Get Treatment
It is advised to book in for an appointment so a consultation can be done and a plan individualized to you can be made. Often treatment to optimize fertility, depending on diagnosis, is recommended weekly for 3 months. Herbals, supplements and Acupuncture are all common fertility treatments.
For an IUI, as it is very similar to a natural cycle, treatments are recommended weekly during the IUI cycle and a pre IUI treatment done within 24 hours of your appointment. During this pre IUI, protocol points will be used and treatment will be focused on relaxing the mind and body,
With IVF, it is always recommended to consult with your practitioner to discuss what treatment outline will be most beneficial for you. Typically once medications are started usually 2 weeks leading up to your IVF menstrual cycle, treatments will be done weekly. A pre transfer 60 minute treatment is done up to 24 hours before the transfer, protocol points will be used and treatment will be focused to help relax the body and mind. After the transfer a post transfer treatment is done for 30 minutes to assist implantation. There is also often benefit in doing a post retrieval treatment to help decrease any inflammation that may have been caused from the retrieval process. Protocol points are derived from a
With Miscarriage it is best to book in for an initial consultation so a treatment plan can be made specific to you and your body. There is no time that is too soon. If you've just had a miscarriage, Acupuncture can help regulate your body and support you while your hormones balance out. If you've just found out your pregnant, book in at your earliest convenience to get support with Acupuncture for your first trimester. If you're ready to start trying again, depending on what your history is, Acupuncture can help balance out your cycle if needed and nourish your body to increase follicular quality, thus creating a healthy embryo.
Protocol points are derived from the IVF study shown below
Abstract - "Use of Acupuncture Before and After Embryo Transfer"
Nick Dalton-Brewer, David Gillott, Nataly Atalla, Mohamed Menabawey, Pauline Wright, & Alan Thornhill
The London Bridge Fertility, Gynaecology and Genetics Centre, London, UK
All IVF cases in which acupuncture was administered before and after embryo transfer at a large private infertility centre were reviewed for a 2-year period. All patients were treated by the same practitioner (NDB) using Traditional Chinese Acupuncture (TCA). Patients received acupuncture to the protocol developed by Paulus, W.E., Zhang, M., Strehler, E., El-Danasouri, I., and Sterzik, K. (2002). Influence of acupuncture on the pregnancy rate in patients who undergo assisted reproduction therapy. Fertility & Sterility, 77, 721–724: Liver 3, Spleen 8, Stomach 29, Pericardium 6, GV 20 were manually stimulated five times over a 40-min period, at Bridge, approximately 10–20 minutes prior to embryo transfer. Embryo transfer was carried out under ultrasound guidance as per routine at Bridge. Ten minutes following embryo transfer acupoints Spleen 6, Stomach 36, Spleen 10, Large Intestine 4 were manually stimulated five times over a 40-min period before discharging the patient. Ear points 34, 55 and 58 were used in both treatments and not stimulated.
A total of 71 patients underwent 74 cycles involving acupuncture before and after embryo transfer. Overall, positive pregnancy rates/ET were 44.6% comparing favourably with the non-acupuncture historic control group. When analysed by maternal age at time of treatment, biochemical pregnancy results for acupuncture treated women were as follows: <35 years−52%; 35–39 years – 45%; 40–45 years – 35%. Results for women aged 35–39 years and those over 40 years were markedly better than controls suggesting that acupuncture intervention of this type may be more effective in older women. No side effects or complications were experienced by women receiving acupuncture. Acupuncture is a safe, adjunct therapy in IVF and in other randomised clinical trials has been shown to significantly improve outcomes when used at the IVF centre before and after embryo transfer. Our preliminary data are encouraging and suggest that a trial involving older women may be effective.
Author: Dalton-Brewer N et al
Publication Date: 2010 Vol 12 No 4 212 - 255
Publisher: Human Fertility