Assisted Fertility IVF

hand with egg

Frequently Asked Questions

Tracey can offer plenty of advice to improve your fertility chances before going down the IVF route. Acupuncture has a good track record at improving fertility status.

 

For many couples the biological clock is ticking, they have been trying unsuccessfully for year or so, and so assisted conception is becoming a consideration. For others, challenges to natural conception have been identified: hormonal imbalances, blocked fallopian tubes, poor sperm quality and so on. Assisted conception has been advised as the best option. If you are undecided though and would like to try naturally before going down the assisted conception route, Tracey is happy to work with you. Depending on your health and lifestyle, allow up to 6 months. The egg and sperm take about three months to develop and nutrition changes require a similar time to fully take effect. It is useful to get some basic fertility tests done if you have been trying unsuccessfully for a while. See your GP first. These test results then can be included in your initial consultation with Tracey. A comprehensive questionnaire will assess you and your partner’s fertility status, potential areas of weakness, lifestyle and diet.

Research shows acupuncture can improve your IVF chances of success. Tracey can also offer plenty of advice to improve your chances further. Even if you’ve had a number of failed IVF cycles, Tracey’s advice, treatment and support can turn that record round.

 

Preparing for IVF and other assisted fertility treatments is very important.  The regime of drugs and emotional roller-coaster is often demanding and stressful.  Ensuring you and your partner are healthy both emotionally and physically can counteract these effects.  This can improve your conception chances.  If you’ve experienced failed IVF cycles you are likely to feel negative, anticipating failure or not daring to believe it is possible.  You may see your body as failing you.  Tracey can help change your mindset and help you once again believe a pregnancy and baby are possible for you.  Acupuncture prepares and enhances your body’s response to the IVF drugs.  The British Medical Journal in 2008 reported a study of 1,366 women who had undergone IVF. The authors concluded

“acupuncture increased odds of clinical pregnancy by 65% compared with controlled groups and 95% increase in odds of a live birth”.

Reference: British Medical Journal (2008): Effects of acupuncture on rates of pregnancy and live birth among women undergoing in vitro fertilisation: systematic review and meta-analysis.  Eric Manheimer et al.  

More recent research shows that acupuncture and moxibustion can lead to better chances of a successful pregnancy for women with previous IVF failures. Researchers carried out a prospective randomised controlled trial with 84 patients who experienced at least two unsuccessful IVF attempts. Four sessions of acupuncture were carried out at key stages in the IVF procedure.  The clinical pregnancy rate in the acupuncture group was found to be significantly higher than in either the control or sham groups; 35.7% compared with 7.1% and 10.1% respectively. (Sham acupuncture is where needles at put in non-acupuncture points.)

Reference: Influence of acupuncture on the outcomes of in vitro fertilisation when embryo implantation has failed: a prospective randomised controlled clinical trial.  Villahermosa et al 2013. Acupunct Med Jun;31(2):157-61. doi: 10.1136/acupmed-2012-010269. Epub 2013 Mar 19

Acupuncture has been shown to increase your chances of IVF success and live birth. It’s the number one complementary therapy recommended by fertility clinics. It increases blood flow to your ovaries and womb (uterus) lining, reduces stress and gives you a positive sense of wellbeing by boosting your feel-good endorphins. Research has established possible ways to explain how acupuncture may benefit fertility:

  • Regulating fertility hormones – stress can disrupt the function of hormones in the body. It is thought to influence female menstrual cycles (so ovulation and egg quality) and sperm quality (count, shape and motility). Going through assisted conception treatment is stressful. Acupuncture counteracts these effects and for the woman allows the fertility drugs to have their full effect.
  • Increasing blood flow to the reproductive organs – this enhances hormone, nutrient and oxygen delivery to the growing eggs and sperm. Research has also shown this improved blood flow increases the womb lining and so chances of implantation of a fertilised embryo (see section below on treatments for fresh IVF cycle for research studies). If you are chronically stressed one of the consequences of could be decreased blood flow to the reproductive organs, so impacting on the quality of your eggs and sperm (read more on my blog about Stress and fertility for women and men)

The British Acupuncture Council presents the latest research on acupuncture and assisted conception.  Jane Lyttleton is a prominent acupuncturist and her clinic is involved in the latest fertility research. Her clinic site has compiled research which looks at different aspects of fertility and acupuncture, such as how acupuncture impacts on sperm quality, endometriosis, PCOS and the role of stress. Read the research reviews.

A comprehensive questionnaire will assess your health and emotional wellbeing. Areas of weakness, lifestyle and diet will be noted. If you have any test results, please bring them with you to the appointment. A treatment plan will be discussed with you.

The number of sessions will vary depending on where you are in your assisted conception cycle. As the egg and sperm take about 3 months to develop then seeing you prior to the start of medication is preferable. Though for a woman the ovarian follicles which the eggs develop within takes one year to mature and at about 6 months these follicles start to respond to their environment as they have grown their own blood supply; consequently a woman should ideally be starting acupuncture 6 months prior to her Embryo Transfer. This blood supply is critical to the effective delivery of reproductive hormones and nutrition to the follicles. Colour Doppler Studies show that the development of follicles is directly correlated with their circulatory supply1. Further studies shows that acupuncture improves ovarian and uterus blood supply and therefore may potentially improve circulatory supply and hormone nutrient delivery to these follicles2. This will influence egg quality. If you discover on the day of your ‘trigger injection’ several smaller follicles (10-15mm), experience shows that acupuncture on the day before egg retrieval can increase the number of mature eggs retrieved from these follicles. We will look at diet and any other lifestyle factors that you can do to improve the success rates of your IVF.

For the woman, you will be either on a short or long protocol. Acupuncture during ‘down regulation’ for the long protocol aims at increasing blood flow to the uterus and improving egg quality. Weekly sessions are recommended, until the Stimulation phase (see below), then session frequency may be increased. Also it is useful for the man to receive acupuncture too, to reduce stress and increase sperm quality.

If you are on a short protocol or during the stimulation cycle, treatment will be strongly focussed on blood flow to the ovaries and uterus, increasing follicle recruitment and development, so enhancing egg quality and improving lining thickness (endometrium) of the uterus. Reducing stress at this time is very important. The Stimulation phase usually lasts 12 days and acupuncture every 4 days or twice weekly is recommended, particularly if you experienced failed IVF cycles in the past.

After egg collection a treatment the next day is recommended for women experiencing discomfort. This is often when a large number of eggs have been collected. The treatment aims to lessen bloating, reduce any local tissue trauma and prepare a calm environment for the arrival of an embryo.

Research has shown that acupuncture before and after the embryo is transferred to the uterus increases conception rates by 16%3. These sessions should ideally be on the same day as the embryo transfer, though experience is that within 24 hours is adequate. If you are intending only to have these sessions and never had acupuncture before, a treatment before egg collection is recommended also. This will enable you to become familiar with acupuncture and allow for a consultation to be undertaken without reducing your treatment time at transfer.

If the man has no known sperm problems, a session before sperm collection is recommended to reduce stress, which can impact negatively on sperm quality. This should not be the first experience of acupuncture and a familiarisation session is strongly recommended a few days before.

If you’ve experienced unsuccessful IVF cycles previously, your treatment plan may need to be altered from the framework outlined above to ensure we optimise your chances of success. The timing and ‘dosage’ of acupuncture, like taking your IVF drugs, is important for the best outcome.

References

  1. (a) Gougeon A. Regulation of ovarian follicular development in primates: facts and hypotheses. Endocr Rev 1996; 17:121-55.  And (b) Balakier H, Stronell RD. Color dopller assessment of folliculorgenesis in in vitro fertilisation patients. Fertil Steril 1994;62: 1211-55
  2. (a)Ho M Huang LC, Chang YY, et al. Electroacupuncture reduces uterine artery flow impedance in infertiles women. Taiwan J Obstet Gynecol 2009; 48: 148-51.  And (b) Stener-Victorin E, Waldenstrom U, Andersson SA, et al. Reduction of blood flow impedance in the uterine arteries of infertile women with electro-acupuncture. Hum Reprod 1996; 11:1314-7.
  3. Paulus WE, Zhang M, Strehler E, El-Danasouri I, Sterzik K. Influence of acupuncture on the pregnancy rate in patients who undergo assisted reproduction therapy. Fertil Steril. 2002 Apr;77(4):721-4.
The focus of acupuncture is on reducing stress and anxiety, improving blood flow to womb to increase the lining and so implantation success. The number of sessions will depend on your medication cycle. Usually weekly sessions are advised. However at embryo transfer two sessions on the day of the transfer are recommended. Research has shown that acupuncure before and after the embryo is transferred to the womb increases conception rates by 16%1. If you are intending only to have these sessions and never had acupuncture before, a treatment a few days prior to the transfer is advised. This will enable you to become familiar with acupuncture and allow for a consultation to be undertaken without reducing your treatment time at transfer.

References

  1. Paulus WE, Zhang M, Strehler E, El-Danasouri I, Sterzik K. Influence of acupuncture on the pregnancy rate in patients who undergo assisted reproduction therapy. Fertil Steril. 2002 Apr;77(4):721-4.
The number of sessions will vary depending your circumstances and will be discussed at your first consultation. As the embryo and sperm take about 3 months to develop then seeing you prior to the start of medication is preferable. In this time we will be influencing egg and sperm quality. We will look at diet and any other lifestyle factors that you can do to improve the success rates of your IUI. As a minimum, a session for the man on the day or day before sperm collection is recommended. For the woman, a session before and after insemination is suggested to reduce stress and balance hormones. If you plan the minimum number of acupuncture sessions and have never experienced acupuncture before, then a session prior to the sperm collection and insemination sessions is strongly recommended. This allows for a thorough consultation and for you to become familiar with how acupuncture feels, so this will not be a concern on the day.

Research has shown acupuncture may help with these issues during IVF:

  • Poor follicular development – too few follicles develop during the ovarian stimulation phase.
  • Follicles develop too slowly or too quickly.
  • Immature or no eggs found in your follicles.
  • Suboptimal endometrial or uterus lining – less than 6/7mm thick (optimal for implantation and ongoing pregnancy is 9 -10mm).

Orthodox medical interventions will include altering your drug protocol or surgery. Acupuncture can be used to support this treatment, as most research shows it improves the quality of the follicles and eggs within them by improving blood flow to the ovary1.  Similarly acupuncture has been shown to improve uterus or endometrial lining by enhancing blood flow2.

The timing and ‘dosage’ of acupuncture is important to success. Research where acupuncture was shown to be successful was based on more frequent sessions during the stimulation phase of IVF and at embryo transfer time3.  Contact me before your next round of IVF. After a consultation and treatment, a plan to enhance your response to your IVF drugs will be discussed with you. In the stimulation phase this may mean you will need two treatments each week to ensure we optimise your chances of a positive outcome. Please plan for this possibility in your schedule.

References

  1. Stener-Victorin E1, Kobayashi R, Kurosawa M. Ovarian blood flow responses to electro-acupuncture stimulation at different frequencies and intensities in anaesthetized rats. Auton Neurosci. 2003 Oct 31;108(1-2):50-6.
  2. Stener-Victorin E, Waldenstrom U, Andersson SA, et al. Reduction of blood flow impedance in the uterine arteries of infertile women with electro-acupuncture. Hum Reprod 1996; 11:1314-7.
  3. Villahermosa DI1, Santos LG, Nogueira MB, Vilarino FL, Barbosa CP. Influence of acupuncture on the outcomes of in vitro fertilisation when embryo implantation has failed: a prospective randomised controlled clinical trial.  Acupunct Med. 2013 Jun;31(2):157-61. doi: 10.1136/acupmed-2012-010269. Epub 2013 Mar 19. 
Most fertility clinics welcome that their clients are receiving acupuncture and it is good to inform your consultant of this.

Angela 35, low ovarian reserve

Angela came to me to improve her chances of conceiving through IVF. She had been trying for a baby for one and half years. She was often losing control and angry at not been able to get pregnant. I gave her 5 treatments before she entered the IVF cycle to prepare her eggs and uterus, and balance her emotions. Tests revealed low ovarian reserve and high follicle stimulating hormone levels and a uterine polyp. Her next 8 treatments were timed to coincide with her IVF treatments. She produced 5 best quality embryos, and only one blastocyst was transferred back, as the consultant thought a pregnancy was likely. We did a treatment to encourage implantation within one hour of the transfer. Angela contacted me two weeks later to say she was pregnant.

 

Elizabeth 33, unexplained infertility

Elizabeth had been trying to have a baby for two years, tests revealed no problems. She had decided to try IVF; this was her second try. I gave her 7 treatments timed to support her IVF treatment. A scan revealed 4 follicles in each ovary, compared to only one follicle at her last IVF try. Two good quality blastocysts were transferred back, one implanted and she is now happily pregnant.

Ask A Question?

Back to top