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.

 

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Preparing to conceive – weight loss

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.

 

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Preparing to conceive – egg quality

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, it makes good sense to try to optimise reproductive health  by improving delivery of  nutrition to the developing egg and enhancing its capacity to make energy (see below).

 

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Preparing to conceive – sperm quality

Lifestyle factors make a big difference to the health of sperm, and the good news is that most of it is under your control. For many years clinics in China have used Chinese herbal formulas to treat male factor fertility.

Many clinical trials in several different countries have demonstrated the possible benefit of acupuncture to certain sperm parameters (references). However the heterogeneity of the trial designs and their reporting mean that the pooled analysis does not allow us to draw firm conclusions yet.  Acupuncture in these trials is applied to the abdomen and the lower legs. Mild electro-acupuncture has been shown to increase blood flow through the small blood vessels of the testes, indicating a possible way to improve delivery of nutrients to developing sperm. Thus acupuncture could be considered as part of a pre-conception programme even where there is a normal semen analysis.
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Preparing to conceive – weight gain

Being under weight affects ovary function, as much as being over weight does (although in a different way). Acupuncture can help to regulate the sympathetic nervous system (reducing adrenalin) and improve appetite. In conjunction with behavioural and dietary modifications this can help to put weight on.

Preparing to conceive – a regular menstrual cycle

One of the things mentioned a lot in a traditional Chinese medicine gynecology 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 gynecological disorders. A regular menstrual cycle is an indication of good ovary function and good hormone balance.

 

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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. It is thought that acupuncture may modulate immune function possibly through its ability to increase endorphins and other neurotransmitters.

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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.

 

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Preparing to conceive – endometriosis

Endometriosis reduces fertility by damaging ovary function (AMH is reduced) and negatively impacting the immune milieu (inflammatory cytokines are raised) and affecting 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.

 

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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 may be employed to try and 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.

 

 

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. This is why we do specific acupuncture treatments at particular times of 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.

 

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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.

 

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