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 has often been used, as part of a comprehensive programme, to help reduce appetite and improve 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 aid weight loss in a safe and stable manner.  We use gentle electro acupuncture and Chinese herbal medicine to help reduce BMI. We have found it to be particularly helpful in reducing waist circumference in women with PCOS. Acupuncture appears to have an effect in reducing the level of specific hormones which affect appetite and metabolism.
Stimulation of ear acupuncture points is often used to help with weight loss. Certain ear points have been shown to stimulate the auricular branch of the vagal nerve and raise 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 it has been suggested that larger trials be done 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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Preparing to conceive – a regular menstrual cycle

One of the things mentioned a lot in a traditional Chinese medicine gynaecology textbook, including the chapter on fertility, is the term “Regulating the Cycle”. What this refers to is the ideal of a 28 day menstrual cycle (give or take a few days), and a regular ovulation occurring around the middle of that cycle. This is one of the first aims of much TCM treatment of gynaecological disorders. A regular menstrual cycle is an indication of good ovary function and good hormone balance.

Schedule: acupuncture once a week for 3 cycles.

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Preparing to conceive – immune factors

Implantation of the embryo in the uterus is a vital and pivotal event which determines the success of an ongoing pregnancy after conception, or after transfer of an embryo in an IVF cycle.
The crucial role that the immune system plays in the process of implantation and the development of the placenta is gradually being elucidated though there is much we still don’t know. A positive finding of immune factors like anti-cardiolipin antibodies, anti- thyroid antibodies, anti-nuclear antibodies or an excess of some types of NK cells can indicate that there may be subtle imbalances in the immune environment of the uterus which are not conducive to establishing a healthy pregnancy.

Most women diagnosed with immune factors affecting fertility will be prescribed drugs to dampen the immune system and/or to reduce blood clotting. Although we are awaiting research to elucidate mechanisms, some patients will choose to have acupuncture as an adjunct therapy. We know that acupuncture is effective at increasing endorphins and other neurotransmitters, and it is thought that acupuncture may modulate immune function through this action. While we don’t yet know the mechanism, the increase in implantation rates in some of the acupuncture studies on IVF patients has been suggested to possibly be related to a regulation of intra-uterine immune factors.

 

Schedule; acupuncture once a week, twice a week at time of ovulation, or on the day of embryo transfer. Read More

Preparing to conceive – PCOS

Women with PCOS, particularly those with irregular or infrequent periods, have their own particular challenges when it comes to conceiving.  We don’t yet fully understand the causes of PCOS however we do know that certain acupuncture protocols can reduce some of the factors that operate to prevent polycystic ovaries working properly. For example some studies show that acupuncture reduces testosterone and LH (luteinising hormone) levels promoting the conditions for more frequent ovulation and better quality eggs. (references)

Patients with PCOS who are trying to conceive naturally or planning to do IVF, may benefit from doing a course of acupuncture over 3 to 4 months to improve ovary function. For those PCOS patients who do IVF, certain acupuncture protocols during the stimulation phase and after embryo transfer have been shown to reduce the risk of hyperstimulation.

Low intensity gentle electro-acupuncture is applied to points on the abdomen and the legs.

Suggested Schedule: Acupuncture 1 – 3 times a week until regular ovulation is re-established, until you conceive or for 3 months to prepare for IVF.

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Preparing to conceive – endometriosis

Endometriosis can damage ovary function (AMH is reduced in endometriosis patients) and can negatively impact the immune milieu (inflammatory cytokines are raised) and affects the lining of the uterus and its implantation sites. We use acupuncture to manage the symptoms of endometriosis like pain and menstrual disturbance. Chinese herbs are sometimes used in China to improve response to IVF drugs and pregnancy rates in endometriosis patients.

Acupuncture is best performed at specific times of the menstrual cycle. These will be decided in conjunction with your practitioner and will depend on your symptom picture and whether or not you are actively trying to conceive.

Suggested Schedule: Acupuncture once a week or fortnight. Chinese herbs daily (when not taking IVF drugs)

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Preparing to conceive – fibroids, polyps and cysts

Obstructions to implantation, such as polyps or fibroids, are usually removed surgically. In the case that surgery is not desired, and fibroids are not large, then Chinese herbal medicine has a long history of being used to shrink them.   Some of the symptoms caused by ovarian cysts  (such as pain or cycle irregularity) may also be amenable to treatment with Chinese herbs and acupuncture.

Suggested Schedule: Acupuncture once per week for 2 – 3 cycles, herbs daily.

 

Preparing to conceive – stress management

Stress, for most of us living and working in modern cities, is part of life. However it can get a lot worse when you are not conceiving as easily as you thought you would. And in a cruel vicious cycle, stress can have a negative impact on fertility. Women who are more stressed have reduced fertility, and during IVF cycles have lower embryo implantation rates. Stress has also been shown to affect semen quality.

For all these reasons acupuncture can be useful at specific times of the menstrual or the IVF cycle.

Acupuncture is well known for its ability to relax the patient and this has been demonstrated in an IVF setting.  Its action in raising endorphin levels and reducing adrenalin and cortisol levels allows the body and mind to relax immediately and learn a different way of being. Our patients frequently comment on how relaxed they feel after their treatments.

Suggested Schedule; acupuncture once or twice a week or as required.

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Preparing to conceive – sleep quality

The connection between sleep and fertility is not always self evident, although getting to bed early with your partner may for some couples have obvious benefits.
You may not realise that the quality and quantity of your sleep influences sex hormones, sperm production, ovulation, immune factors, weight gain, mood, stress levels and longevity as well as the more obvious stamina.

Getting enough good quality sleep is an essential part of preparing for conception for all these reasons. Acupuncture has a proven track record (reviewed in several medical journals) of assisting to establish sound sleep patterns.

Schedule: acupuncture 1-2 treatments per week.

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