Specialist treatment clinic: Gynaecology and andrology

Female infertility

Frequently asked questions:

• What are the advantages of traditional Chinese Herbal Medicine and the nutritional approach?
• Can I take Chinese Herbs and nutritional supplements while on a drug schedule from an IVF Clinic or whilst doing IUI?
• I am a 40+ female. Does this affect treatment?
• Can I use Chinese Herbs and nutritional therapy to help my constitution even if I'm not classed as infertile?
• What can I expect from a treatment?
• How often will I have to take the herbs and nutritional supplements for, and for how long?
• I’ve heard that acupuncture improves IVF success rates, is this true?
• Are Chinese Herbs and nutritional supplements safe?
• What research has been done?

What are the advantages of traditional Chinese Herbal Medicine and the nutritional approach?

Even if you have not been classified as infertile preparation for pregnancy, which includes acupuncture, Chinese herbal medicine and detox nutrition for at least 3-4 months prior to conception is advised. Regardless of your present health, it’s possible to have a positive affect on the vitality of both the egg and sperm.

Both Chinese medicine practitioners and nutritionists and look at the timing of menstruation and whether it is balanced. For example is the cycle regular? Does it have a certain pattern? Or no pattern at all? Is it shorter or longer than average? If shorter than 26 days, the focus of the treatment is to lengthen it. If the first phase (before ovulation) is shorter than ten days we aim to lengthen it. Simply attending to the timing of the cycle can attend to the underlying imbalances causing sub normal fertility.

That said, Traditional Chinese Medicine and nutritional therapy sees the person as an integral mind/body organism. Therapy does not treat just symptoms or diseases. Instead, it ventures to stimulate the body's natural healing potential by treating root causes, therefore your overall health and vitality will improve also as well as your reproductive system.

Can I take Chinese Herbs and nutritional supplements while on a drug schedule from an IVF Clinic or whilst doing IUI?

Traditional Chinese Herbal Medicine, and nutritional therapy used in the treatment of infertility, minimises undesirable side effects and accumulated toxicity from invasive procedures and drug therapies, known and unknown. Our practitioners will not give any herbal procedures where they are unsure of its reaction with western medicines. If taken 3 –4 months before, it can be used to strengthen and balance one's general health so that IVF, GIFT, ZIFT, ICSI, AHT and TET procedures are more effective. Even a six-week acupuncture, Chinese herbal medicine and nutritional programme prior to commencing IVF or IUI are beneficial.

I am a 40+ female. Does this affect treatment?

Whatever your age, if you have a history of either numerous fertility drugs (over 3 cycles), birth control pills, PMS, ART procedures, elevated FSH, polycystic ovaries, endometriosis, or a history of drug, alcohol, or smoking abuse, it will usually take longer to balance the reproductive system. Generally though, you should be focussing realistically on four - six to nine months before expecting to evaluate the results.

Can I use Chinese Herbs and nutritional therapy to help my constitution even if I'm not classed as infertile?

Yes, absolutely. The widespread use of traditional Chinese Medicine and nutritional approaches suggests that they can be used with or without the integration of Western medical techniques. The integration of Western techniques as we know them, began in the Orient less than a century ago.

What can I expect from a treatment?

The Chinese medicine practitioner aims, during the first consultation, to determine the nature of the disharmony by careful questioning and observation. Diagnosis may include examination of the tongue for its structure, colour and coating and of the pulses at the wrists, which are felt for their quality strength and rhythm.

There is no set number of treatments, as this depends on each individual case. There are varying acupuncture, Chinese herbal medicine and nutritional protocols that we use. However characteristically, if treating with Chinese herbs and nutrition alone, once every two weeks or once a month is sufficient.

Chinese herbs will usually combined with Acupuncture, nutritional therapy, Exercise, and Lifestyle Management to optimise your chances. Nutritional therapy will involve a complete assessment of your current nutritional regime, and will devise a new plan along with nutritional advice to ease you into optimum health. Very often this will involve further nutritional tests such as hormone profiles to further refine your treatments effectiveness.

How often will I have to take the herbs and nutritional supplements for, and for how long?

Generally we will recommend weekly acupuncture for the women from the first day of medication through to embryo transfer, whilst also taking nutritional supplements and Chinese herbs if necessary. Whether you are having Acupuncture alone, or taking Chinese Herbs, and nutritional supplementation, the consistency of treatment is of vital importance. This is especially true for women, as there are specific hormonal adjustments that need to be made at each week of the cycle. Missing a week of treatment may mean that you lose an important opportunity to heal a particular segment of the four-phase cycle. It takes three cycles to complete the foundations of regulation, regardless of biological age. That said, we would support you in whatever time frame you have, and even just six weekly treatments before your IVF or IUI schedule is of benefit.

I’ve heard that acupuncture improves IVF success rates, is this true?

Yes, our practitioners have an in-depth knowledge and understanding of the IVF process. Research has shown that acupuncture can boost fertility.

Our practitioners use a combination of acupuncture, Chinese herbal medicine, and nutritional therapy using an evidence-based approach for those trying naturally and those going down the assisted fertility route. Putting the building blocks in place before your IVF schedule is the key. Getting the cycle into balance is important to the success of the IVF treatment. Issues such as PMS, fibroids, PCOS, and painful periods are all signs of imbalance which need addressing.

A detailed history will be taken and different acupuncture points will be used depending on where you are in your IVF / natural cycle. Following the initial consultation, you will need acupuncture on a weekly basis before your IVF schedule. During your IVF schedule we would need to see you weekly again, and during early pregnancy to help secure it, and may also use Chinese herbal medicine depending on your history.

Acupuncture and Chinese herbal medicine can help at specific stages in the IVF schedule:

Fertilisation

IVF techniques are particularly good at getting the egg and the sperm together. In cases where there is a tubule blockage or the sperm is unable to reach its destination, IVF creates a solution. ICSI can be employed if the sperm are unable to fertilise the egg. Using Chinese medicine over a long period of time (1 year or more) can usually help very compromised sperm.

Good embryos

The early development of the embryo depends on the function of the quality of the sperm and egg, how they come together, and the compatibility of the genetic material. As such, both Chinese medicine, to improve quality of gametes, and IVF, to help the two get together, can help.

Good tubes

Well functioning tubes are necessary in natural conception, but not for IVF. Chinese medicine aims to improve the elasticity, the secretions and the internal environment of the fallopian tubes, but for absolute obstructions micro surgery is required or IVF can be employed to by pass the tubes altogether. Acupuncture is thought to be useful in facilitating movement in the tubes and preventing spasm of the fine muscles in the walls of the tubes.

Good uterine lining

Studies during IVF have shown that pre ovulatory endometrium thickness and ultrasound appearance is predictive of embryo implantation results. Anything less than 9-mm sagittal thickness, is associate with about a 5-fold reduction in live birth rate per embryo transfer. Women with poor development have a history (thus far) unexplained IVF failure or early recurrent miscarriage.

Using Chinese medicine increases the thickness and the quality of the lining of the uterus. It does this by promoting corpus luteal function in producing high levels of progesterone and increasing blood flow to the uterus. Patients who have taken Chinese herbs before and after egg pick up often report unusually high progesterone readings.

Implantation/embryo transfer

If the embryo is a strong one, and the stage and extent of development the endometrium is good, it is expected to produce a success implantation. At this stage, bar ensuring the embryos are transferred at the right time - IVF has little more influence. However acupuncture and Chinese medicine can influence blood flow to the uterine lining the hope of encouraging implantation, as can aspirin, which is now prescribed as part of many IVF protocols. We recommend an acupuncture treatment before and after embryo transfer to improve pregnancy rates. Ideally, this is recommended on the same day as close to your embryo transfer appointment.

In the weeks after the embryo transfer we recommend weekly acupuncture treatments before you take a pregnancy test. If all the steps above leading up to this point has been successful - then Chinese medicine can still be of benefit.

Viable pregnancy

Chinese herbal medicine and acupuncture is sometimes used in the early stages of preganacy if there are any signs that the women's body is weakening and a miscarriage threatens, or where there has been a history of miscarriages. Women mostly are supported until wk 12, where conditions such as morning sickness, sciatica, and pelvic pain can be treated during preganacy, as can problems with sleep and digestion. At the later stages, Chinese medicine is used if the babies' growth is not optimal, and even later again acupuncture will be sought if the baby is long overdue (reference: Jane Lyttleton, Treatment of infertility with Chinese medicine, 2004).

Are Chinese Herbs and nutritional supplements safe?

Chinese Medicine has been used as front line medicine by the majority of the world's population since before recorded history and is still the most widely utilised medical system in the world today. Adverse reactions to Chinese herbs are extremely rare and are negligible when compared to those commonly produced by pharmaceutical drugs. Both professional Chinese medicine practitioners and nutritionists are aware of the safety issues surrounding mixing treatment with western drugs, and will always be up to date with current findings. Where there is no information, then our practitioner swill always err on the side of caution.

What research has been done?

Acupuncture and IVF treatment for infertility

Effects of acupuncture on rates of pregnancy and live birth among women undergoing in vitro fertilisation: systematic review and meta-analysis. A recent meta-analysis reported in the prestigious British Medical Journal of 7 clinical trials involving 1366 women who underwent IVF treatment for infertility has found that acupuncture, administered within a day of embryo transfer, led to significantly increased rates of pregnancy and live births when compared to either sham (pretend) acupuncture or no acupuncture at all. Women who received acupuncture were around 65% more likely to become pregnant and 91% more likely to have a live birth.

The authors of the study conclude: “Current preliminary evidence suggests that acupuncture given with embryo transfer improves rates of pregnancy and live birth among women undergoing in vitro fertilization”. This is a significant endorsement for the use of acupuncture as part of the standard care programme during IVF treatment. Read more here: www.bmj.com/cgi/content/full/bmj.39471.430451.BEv1

A Briefing Paper, which reviews the evidence of effectiveness of acupuncture in the treatment of PMS by The Acupuncture Research Resource Centre (ARCC) is available in PDF format for download. Other review papers for other conditions are available from ARCC.

Please also make use of our dedicated research section to view further news and research on this topic. The British Acupuncture Council's news page is a great resource from articles to research showing the benefits of acupuncture for a range of conditions. Visit www.acupuncture.com for more interesting acupuncture research and information.