Acupuncture to prepare for frozen embryo transfer

Many IVF clinics like to transfer embryos into a natural environment. Embryos that have been frozen and successfully thawed are transferred back into a uterus in its natural state at exactly the right time for implantation. Using electro-stimulation on acupuncture points on the abdomen in the months and weeks before the transfer, has been shown to improve the structure of the uterine lining, and significantly enhance the implantation and pregnancy rate.

Schedule; 1-2 treatments per week in the 2-3 cycles before frozen embryo transfer

Preparing to conceive – a healthy diet

There is much information and misinformation about what constitutes a good preconception diet. From a Chinese medicine point of view the middle road is usually the healthiest where moderation of some foods is recommended and a good balance of healthy and fresh fruits and vegetables with adequate protein is encouraged. A TCM practitioner takes into account the different constitution and situation of each individual before dietary advice is given.

A properly functioning digestive system is an important focus of treatment, so that nutrients are absorbed and utilised well. If there are any digestive issues such as bloating, bowel disorders, reflux, cravings or low appetite these can be addressed with acupuncture.

Schedule; Acupuncture once a week if there are digestive symptoms, until symptoms improve.

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Preparing to conceive – weight loss

If you are overweight a little bit of weight loss goes a long way to improving fertility. Losing 5 kg is a manageable target for most and you can start now. Just moving your metabolism a little bit in the direction of burning off fat stores, can stimulate ovarian activity, improve egg and sperm quality and increase fertility.

Acupuncture can be used to help reduce your appetite and improve your metabolism to promote weight loss. An analysis of your constitution and the reasons for your weight gain by an experienced acupuncturist will lead to an individualised treatment plan designed to maximise weight loss.  We use gentle electro acupuncture and Chinese herbal medicine to help to reduce waist circumference and abdominal obesity. Acupuncture can reduce the level of specific hormones which affect appetite and metabolism.
Using acupuncture points on the ear stimulates the auricular branch of the vagal nerve and raises serotonin levels, both of which increase tone in the smooth muscle of the stomach, thus helping to suppress appetite.

Suggested Schedule; Acupuncture 1 – 3 times per week for 1 – 3 months before IVF, or until goal weight is achieved or until you conceive.

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Preparing to conceive – the eggs

The environment that eggs occupy during their lengthy maturation process in the ovary has an impact on what shape they are in before meeting a sperm (with or without an IVF embryologist in attendance).  They need a good blood supply, the right nutrients, the right hormone signals and the capacity to supply enough energy to the embryo.

This has important implications, particularly for eggs that are coming from slightly older ovaries (and possibly for eggs coming from women with PCOS or endometriosis). While no treatment can turn back the clock, or change the DNA, acupuncture and herbs can be used in an attempt to rejuvenate some oocyte characteristics by improving delivery of  nutrition to the developing egg and enhancing its capacity to make energy (see below). While this is purely theoretical at this stage, there are some interesting findings which make it feasible (see below)

Suggested Schedule; Acupuncture once a week, Chinese herbs twice a day for 3 – 6 months

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Preparing to conceive – the sperm

Many clinical trials in several countries have demonstrated a possible benefit of acupuncture treatment to some sperm parameters (references).  A meta analysis of some of these trials indicated that motility and count may be improved by acupuncture but larger trials are needed before definitive conclusions can be reached.

In these trials mild electro-acupuncture is applied to the abdomen and the lower legs. This has been shown to increase blood flow through the small blood vessels of the testes, potentially improving delivery of nutrients to developing sperm and promoting optimal sperm vitality. Thus acupuncture can be considered as part of a pre-conception programme even where there is a normal semen analysis.

Schedule: Acupuncture 1 – 2 times per week for 5 – 10 weeks (10 – 15 treatments in total).
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Acupuncture during the first few weeks of pregnancy

Regular monitoring of the pulse (a TCM diagnostic technique) and regular treatment with acupuncture designed to reduce anxiety may offer you important and reassuring support during these first few weeks of pregnancy. Doctors in NZ showed that regular monitoring and reassurance reduces miscarriage rates in some of their patients. One study in China found that the incidence of miscarriage was reduced in the women to whom they gave Chinese herbs after embryo transfer in an IVF cycle.

Acupuncture has been demonstrated to have significant immune-modulating effects. While no trials have yet been undertaken, this effect may prove to be important in reducing the risk of rejection by the mother’s immune system in the early days as the embryo implants and a pregnancy is established.

Suggested Schedule: 1 treatment per week until week 12 of pregnancy.

Preparing for labour

Acupuncture treatment applied in the 4 weeks before the due date for delivery has been found by some midwifes to reduce the rates of medical induction and emergency caesarian. It also has been shown to encourage cervical ripening and may shorten active phase labour time. (All references). However larger trials are needed to confirm these findings.

Suggested Schedule: 1 treatment per week from week 35 or 36 of pregnancy.

 

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Acupuncture before and during the medication phase of IVF

This treatment schedule is based on protocols used in clinical trials which demonstrate increased blood supply to the uterus and a regulation of hormones which may be important to follicle development and implantation. Recent analyses of the benefit of IVF patients receiving acupuncture have shown that patients who have treatment before and during the stimulation and implantation phases benefit more than those that have acupuncture only on the day of embryo transfer (reference)
Suggested Schedule: 2 treatments per week for 4 weeks (optimal) plus treatment at time of embryo transfer.

Acupuncture on the day of embryo transfer (including frozen embryo transfer)

These one or two treatments are based on protocols used in clinical trials some of which showed an increase in pregnancy rates in certain groups of women receiving acupuncture (most commonly those for whom the expected pregnancy rate was 30% or less). The most recent study has found that such a small “dose” of acupuncture showed no effect on live birth rate in a large population of women of all ages undergoing IVF, compared with sham acupuncture . Some researchers report better results with more frequent administration of acupuncture before and during the stimulation phase of the IVF cycle. (You can find the references for these trials here, and here)
In our clinic we find that IVF patients appreciate the calm and relaxation that acupuncture brings on this special day, and gives them space to honour the arrival of the precious embryo.
Schedule:    a – before or after transfer …… one treatment
                      b – before and after transfer …… two treatments 

Acupuncture at any phase of the IVF cycle

Acupuncture may be useful in managing any side effects experienced during an IVF cycle. Reduced fatigue, stress, moodiness, abdomen swelling and discomfort and other side effects are reported by many women using acupuncture during their IVF cycle. In addition women report greater relaxation and control of anxiety (reference), and overall greater resilience. The acupuncture treatment will be different for each patient and depends on symptoms.
Suggested Schedule: 1-2 treatments per week as needed.