an assisted road to parenthood 👶

So the bumpy and divergent road to parenthood has lead you to Assisted Reproductive Technology (ART) and potentially in-vitro fertilisation (IVF). Nowhere near as fun as the natural (in-vivo) option, but sometimes it’s the only way. All the bliss of parenthood hopefully (joyfully, desperately) awaits, whatever path you take.

There is some research evidence that Chinese medicine treatment may assist in supporting treatments such as IVF, and there is also broad agreement by Chinese medicine practitioners and other health practitioners about acupuncture as an adjunct treatment for IVF.

Every day in clinic we support women and men using acupuncture and herbal medicine as an adjunct to ART; whether it is to nourish the uterus through enhanced blood circulation (Stener-Victorin, 1996), alleviate the discomfort of egg retrieval (Kwan 2018), refresh emotionally by stimulating endorphins, moderating stress and building resilience (Han, 2004; Grant, 2014; de Lacey 2009), or even improving those dodgy sperm parameters (Franconi, 2011).

‘I felt like my being and my soul were being looked after, as well as just to make a baby’ (de Lacey, 2009)

The approaches to fertility treatment using ART, including IVF, and traditional Chinese medicine are completely different, yet for this reason they can complement each other well. Here I will attempt to unpack some of the often contradictory information and evidence about how (and whether) Chinese medicine can help along this journey. Some great further reading describing women’s experiences of the role acupuncture can play is contained in the following article: https://bmccomplementalternmed.biomedcentral.com/articles/10.1186/1472-6882-9-50

Acupuncture and Chinese medicine are considered to be very safe, including in pregnancy, when they are delivered by qualified practitioners. Occasionally (as with all health treatments) there may be mild adverse reactions in individual cases – please talk to your practitioner about any concerns; we love bringing this awesome natural

medicine to the wider world.

Research

Internationally, scientific research into Chinese medicine is active; however, there are therapeutic areas where there is insufficient higher quality clinical evidence. Furthermore, the holistic and highly individualised treatment for patients may not be amenable to scientific studies. Comparisons to ‘sham’ acupuncture also may not give valid findings, since sham acupuncture is not physiologically inactive (Manheimer, 2011), and since we NEVER use sham treatments in clinic, these comparisons are not meaningful anyway. The following mostly describes outcomes when acupuncture or Chinese medicine treatment is added to IVF standard care, compared to IVF alone.

Embryo transfer

While a course of traditional Chinese medicine treatment can typically take 6-24 sessions, depending on the complexity of the issue (Hullender Rubin, 2015), for convenience many studies have assessed the effect of a simplified protocol of just 1-3 acupuncture treatments around embryo transfer day.

While there have been mixed results (Jin, 2018), a recent systematic review of 20 trials reported evidence of a beneficial effect. Women given acupuncture as an adjunct to transfer had significantly higher pregnancy and live birth rates, and reduced miscarriage rates, compared to women who did not receive acupuncture (Smith, 2019).

However, acupuncture on transfer day only may not be an optimal dose. While it could potentially adjust physiology such as uterine blood flow (Stener-Victorin, 1996) or moderate stress levels (Grant, 2014), it is likely to be insufficient to address underlying patterns of disharmony that may be impeding conception (Hullender Rubin, 2015).

Whole systems Traditional Chinese Medicine

Traditional Chinese medicine is an individualised and complex intervention that may include acupuncture, herbal medicine, exercise, massage, dietary and lifestyle recommendations, and is ideally carried out in the weeks and months leading up to the IVF cycle. Lee Hullender Rubin evaluated the records of a US IVF clinic where Chinese medicine was offered to women in the lead up to transfer. Treatment was provided weekly, then 2/week from the start of IVF suppression medications to oocyte retrieval, with an average of 12 sessions. Compared to IVF alone, this combined treatment significantly increased live births (61.3% vs 48.2%) and reduced miscarriage rates (5.8% vs 10.7) (Hullender Rubin, 2015).

There seems to be some evidence of greater benefit in older women, with one study finding success rates of 40% in women aged 35-40 who received acupuncture with IVF, compared to 16.1% for IVF alone (Chelo, 2012). This was also supported in Hullender Rubin’s review. IVF combined with regular Chinese medicine treatment increased live birth rates from 31.5% (standard IVF care) to 54.2% in women aged 38-40, and from 19.2% to 60% in 41-42 year olds, although the sample size was low in the older group (Hullender Rubin, 2017).

Getting through intact, well and strong

While stress impacts on fertility and life with IVF is stressful, it is important to note that feeling stressed, anxious or depressed are completely normal and natural responses to circumstances. Take advantage of counselling and time out from the fertility journey, and seek help when these feelings are unrelenting or overwhelming.

Research shows that depression, anxiety and high levels of stress are partly mediated by the hypothalamic-pituitary-adrenal (HPA) axis and the sympathetic-adrenal-medulla (SAM) axis (Joseph, 2014). These are physiological areas that have been shown to be modulated by acupuncture (Liu, 2018; Anderson, 2012). Acupuncture treatment can support care provided by qualified mental health professionals.

Themes identified in research into acupuncture as an adjunct to IVF emphasise feelings of relaxation, balance and calm. In addition, benefits were noted in sense of perspective, tolerance, vitality, clarity, relationships, restored personal power, sense of wholeness and support (de Lacey, 2009; Grant, 2014). As one woman said, ‘It was like waking up for a new day feeling fresh and ok’ (de Lacey, 2009).

That sounds like a plan. Feel free to chat to us about what we can do together to make your unique path a little more scenic.