I have been wanting to write about acupuncture for a while now on the blog, especially as I get asked so many questions weekly about it's benefits during my Fertilityism Fridays Q&A. My experience with acupuncture started a year before embarking on IVF when I went to see a Chinese herbalist/acupuncturist who specialised in women's health. I had a positive experience but it was not until I moved to South West London and met Justine Hankin that I truly started to understand, learn and experience the benefits of acupuncture and the effect it has on my cycle and fertility. Justine has over 25 years experience in acupuncture specialising in women's health and is truly amazing at what she does.
I used Justine prior to fertility treatment as well as through IUI and both my IVF cycles. She helped me through a very difficult time when I struggled to process and navigate our way through 'unexplained infertility' and undergoing fertility treatment (IUI and x2 IVF rounds). I felt very emotional and scared about IVF and I was holding on to a lot of worry and fear that it just would not work. Justine has a way of truly connecting with you, treating her clients on a physical as well as mental level. Despite my fear of needles, I learnt to love our sessions and truly felt so relaxed and calm after each session, which helped me personally through IVF and early pregnancy.
When it came to writing this blog post, there was only one person I wanted to speak to. I personally found it very difficult to find honest advice on pre-conception nutrition, acupuncture and fertility treatment when embarking on my fertility journey. I truly hope the Q&A below with Justine helps many of you with understanding the benefits of acupuncture when trying to conceive whether that is naturally or with fertility treatment.
How many sessions do you recommend for fertility?
If you decided to run a marathon, the chances are you would train for a few months before the race. Preparing for pregnancy is no different. In order to give both yourself and your baby the best start in life, preparation is key!
However, there is no magic number of treatments for fertility, as every woman is different and has different needs. The strength of acupuncture is that it addresses the individual – therefore no treatment plan will be the same. As a rule of thumb, I recommend a three month course of treatment to fully prepare your body for pregnancy. This is because it represents the full life cycle of the egg; from the start of its journey to ovulation. Therefore, this is the optimal time for acupuncture to try and support your egg health and prepare the endometrium.
I like to see my patients on a weekly basis for the first four weeks and then, after reviewing progress, I usually decrease treatment to twice a month. Depending on your particular needs this might mean you have a treatment during the first two weeks of your cycle, or one treatment pre ovulation and another post ovulation.
Is there a specific time in your cycle that is best to have acupuncture when trying naturally?
Again, there is no one answer to this question, as it very much depends on the individual. The focus of treatment would be different for someone who has a thin endometrium compared to someone else who has a short luteal phase. The aim of acupuncture is to create balance in your body and to support your entire reproductive system, so a one-off treatment for fertility is not really recommended. It is a little like laying a foundation where each treatment builds on the last.
By guiding the body back into balance, acupuncture treatment may help:
Regulate the menstrual cycle and encourage regular, ovulatory cycles
Support ovarian function and help improve egg quality
Improve blood flow to the uterus and ovaries
Increase the thickness and quality of the endometrial lining
Support a healthy luteal phase
Encourage healthy embryo implantation
Support and regulate the immune system
Reduce the chance of miscarriage
Regulate hormones
Reduce stress and anxiety
How exactly does acupuncture help with conceiving?
Acupuncture may help you to conceive because it brings the body back into alignment, both physically and emotionally. Studies also show it reduces stress, increases blood flow to the reproductive organs and helps to balance the endocrine system.
When are the key times to have acupuncture during frozen embryo transfer (FET)?
Current research supports the findings that acupuncture during an IVF or ICSI cycle (long or short protocol) - with increased frequency during ovarian stimulation and at the time of transfer - can have a statistically positive treatment effect on clinical pregnancy and live birth rate.
During Stimulation
During the IVF/ICSI cycle itself I would recommend you have treatment once a week from the start of down regulation. Once you start the stimulation phase, I would recommend you continue treatment once a week, unless the endometrium is too thin (it should ideally be >7.5mm in thickness and triple layer), in which case I would recommend treatment twice a week.
Pre and Post Collection
I then like to see my patients pre and post collection. Pre collection to give the follicles a final boost and also promote emotional wellbeing as it can be a stressful time. Then another treatment immediately after collection, when my focus turns to preparing the endometrium for transfer.
Pre and Post Transfer
I highly recommend you also have acupuncture immediately pre and post transfer.
There are numerous studies which show that having acupuncture treatment pre and post transfer increases the pregnancy success rate. One study found
a pregnancy rate of 42.5% in the group of women who receive acupuncture before and after IVF
a pregnancy rate of 26.3% in women who simply underwent IVF and had no acupuncture
The efficacy of acupuncture alongside IVF is further supported by the fact that more and more fertility clinics advocate the use of acupuncture alongside assisted fertility treatment, with some now having in-house acupuncturists.
When are the key times to have acupuncture during frozen embryo transfer (FET)?
The focus of treatment alongside FET is to try and support and nourish the endometrium to try and maximise endometrial receptivity. Therefore, I recommend treatment on a weekly basis from the start of the cycle – unless the endometrial thickness is an issue; in this instance, I would recommend treatment twice a week.
As with transfer during a fresh IVF/ICSI cycle, I would highly recommend treatment pre and post transfer.
Is it safe to have acupuncture on transfer day?
It is very safe to have acupuncture on transfer day (with a qualified practitioner) and is in fact highly recommended! I would recommend a treatment pre and post transfer – see above.
I have PCOS and am interested how acupuncture can be used to help with this?
Often PCOS can result in irregular periods and acupuncture may be effective in regulating the menstrual cycle. Several studies have concluded that acupuncture is a safe and effective treatment for PCOS and may have a role in increasing blood flow to the ovaries, reducing ovarian volume and the number of ovarian cysts, controlling hyperglycaemia by increasing insulin sensitivity and decreasing blood glucose and insulin levels.
It is important that any treatment is supported by lifestyle factors such as diet and exercise, as well as any medical recommendations.
Does acupuncture benefit the IUI process?
In the same way as acupuncture may benefit natural fertility, it may benefit patients alongside all Assisted Fertility Techniques, including
stimulated cycles
IUI
IVF
ICSI
Frozen Embryo Transfer
Egg donation
Sperm donation
Does acupuncture help prevent miscarriage? If so, how?
Acupuncture may be very useful to help the prevention of miscarriage when not related to chromosomal abnormalities by treating many of the common causes of miscarriage. It may be helpful in:
Increasing the thickness and quality of the endometrial lining
Helping regulate hormones
Reducing uterine contractions in early pregnancy
Regulating the immune system
Stress reduction
How often do you recommend having acupuncture once pregnant?
Pregnancy is the most natural thing in the world and your body knows what to do, so you may not feel you need any further treatment, which is absolutely fine.
However, you may find pregnancy quite a challenging time, as it can sometimes be accompanied by uncomfortable symptoms and emotional stress, where a little extra support is welcome. In these cases, acupuncture is a safe, effective and drug free treatment for all stages of your pregnancy.
There are many different reasons why you may come for treatment at this time, such as:
this is your first pregnancy and you want to ensure you are doing everything possible for a healthy and enjoyable pregnancy. For example, one focus at this time may be strengthening your digestive system to minimise symptoms of morning sickness
or you have a history of miscarriage and you want treatment to support the pregnancy and reduce any anxiety during the first trimester
or you have had IVF and feel you may benefit from further acupuncture treatment. One study found acupuncture may reduce the risk of miscarriage when undergoing IVF
Equally, common pregnancy related ailments may benefit from treatment, such as:
headaches
sinusitis
constipation
heartburn
tiredness
morning sickness
varicose veins
haemorrhoids
depression
stress
anxiety
back pain
carpal tunnel syndroms
symphysis pubis dysfunction
I like to see my patients on a weekly basis during the first trimester. During the second trimester I tend to see patients once a month unless any issues arise. Then from 35 weeks I like to see patients on a weekly basis again, to prepare for labour.
Is acupuncture better than reflexology for fertility?
There are no ‘best’ or ‘better’ treatments - whichever you prefer is the best one for you!
Is acupuncture good for low sperm count?
Yes. Research has shown both an increase in the total number of sperm present and an increase in the number of sperm present without structural abnormalities after a course of acupuncture treatment. Treatment obviously needs to be supported with the necessary lifestyle factors to help sperm production, such as diet, exercise, avoiding heat etc.
Are cold fruit and vegetables as beneficial as hot when nourishing your body and TTC?
No. In Traditional Chinese Medicine (TCM) the Stomach has several different jobs, one of which is to create blood from food. As I am sure you are aware, blood is an important component of fertility; you want the endometrium to be thick and luscious, like a big fluffy duvet, where the embryo can safely snuggle in. Therefore, from a TCM point of view, it is vital to strengthen and support the Stomach to optimise fertility. The best way to do this is to eat warm, cooked foods as raw foods and cold drinks are seen to damage the Stomach energy.
What to wear when having acupuncture?
There is no need to wear anything special when visiting your acupuncturist as they will give you privacy to get ready for treatment. However, if you wear loose clothing it will allow your acupuncturist to access all acupuncture points without you having to undress. I provide a fresh blanket for every patient to ensure you are covered up and warm!
Could you please advise how I can find a good acupuncturist and also any recommendations for Chinese herbs?
You can find a fully qualified acupuncturist by looking at the website of The British Acupuncture Council – simply type in your post code and they will provide you with a list of all acupuncturists in your area.
The BAcC has a membership of around 3,000 professionally qualified acupuncturists and is the UK's largest professional/self-regulatory body for the practice of traditional acupuncture. All acupuncturists listed on the website are fully qualified and are bound by a strict code of conduct.
If you are interested in Chinese Herbal Medicine I would recommend the Register of Chinese Herbal Medicine who will be able to provide you with the contact details of fully qualified Chinese herbalists in your area.
A big thank you to Justine for kindly taking the time to answer these questions, you can learn more about Justine and contact her via her website - https://justinehankin.co.uk.