Clinical Programmes in Chinese medicine gynaecologY
Whether you are preparing to conceive, actively trying to conceive or embarking on IVF, Chinese medicine has a lot to offer you.
The patients who come to our clinic have concerns about irregularity or pain in their menstrual cycle, their response to an IVF regimen, their egg or sperm quality or symptoms in their pregnancy.
At Acupuncture Holistic Medicine, we offer clinical programmes based on existing evidence, our training and experience and the experience of doctors working in gynaecology clinics and hospitals in China over many hundreds of years.
It is important to note that to date there have not been a sufficient number of large scientific, controlled and blinded clinical trials in the West to prove that Chinese medicine treatment provides a cure for infertility.
Preparing to conceive - 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. In the clinic we will ask you about digestive issues such as bloating, bowel disorders, reflux, cravings or low appetite.
Preparing to conceive - 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, the follicular and whole body environment within which the eggs develop is worth looking after.
A discussion about egg quality is usually a discussion about aging. Although it is more common in older women, you don’t have to be in your 40s to have ovaries that are not producing good quality eggs or that are not responding well to IVF drugs. Your FSH may be rising as your pituitary tries to stimulate the ovary that has become less responsive, or your AMH may be low as the follicles themselves have become less active (or there are fewer of them). Some ovaries age more quickly than others and unfortunately neither acupuncture nor Chinese herbs (nor much else) can increase the number of eggs left in the ovary or change their chromosomes.
There are a number of areas of reproductive health that can be supported by Chinese medicine. Each case will be analysed and treated individually according to constitution, symptoms and life situation.
preparing to conceive - sperm
A number of studies in several countries have examined the effect of acupuncture treatment on some sperm parameters. In these trials mild electro-acupuncture were applied to the abdomen and the lower legs.
However while a meta analysis of some of these trials found that motility and count may be improved by acupuncture, larger trials need to be done before definitive conclusions or clinical recommendations can be made.
Lifestyle factors make a big difference to the health of sperm, and the good news is that most of it is under your control.
PREPARING to conceive - A regular menstrual cycle
One of the things mentioned a lot in a traditional Chinese medicine gynaecology textbook, is the term “Regulating the Cycle”. This refers to 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 many gynaecological disorders. A regular menstrual cycle can be an indicator of good ovary function and good hormone balance.
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 reduce immune system activity and/or to reduce blood clotting. Some patients may request acupuncture as an adjunct therapy to steroid treatment to help manage side effects.
While we feel it is too early to offer specific acupuncture clinical programmes for women with immune related issues, some promising research on the possible role acupuncture might play is being done in this area.
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 research being carried out around the world is exploring the impact that acupuncture may have on reducing some of the factors that operate to prevent polycystic ovaries working properly. We are keen to help patients with PCOS, and have seen many women in clinic. Please contact us for more information about a supportive programme for PCOS.
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.
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. Chinese herbal medicine may be a useful addition to the programme in some cases.
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 appear to have reduced fertility, and stress has also been shown to affect semen quality.
Acupuncture is well known for its ability to relax the patient and this has been demonstrated in an IVF setting. Our patients frequently comment on how relaxed they feel after their treatments.
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 as method to assist in establishing sound sleep patterns has been the subject of a number of trials, most with positive findings. Meta-analysis of these trials presents difficulty due to many different trial methods and hence no firm clinical recommendations can be made at this time.
preparing to conceive together
It takes two and this stressful journey is traveled more easily when the two of you do it together, supporting each other. Whether it is unexplained infertility, male factor or ovarian issues, focusing on improving general and reproductive health on both sides often helps. Many of the couples we have seen have voiced an appreciation of the emotional and psychological benefits they experience when they come to the clinic together.