Acupuncture – is it worth doing before and after the embryo transfer?

In this event, Nathan Billings, Holistic Fertility Acupuncture Specialist at Unica Clinic, discussed how acupuncture can impact your final outcome before and after embryo transfer.

Acupuncture is one modality in the much larger system of Chinese medicine. Chinese medicine is a large complex system of healthcare that encompasses acupuncture, Chinese herbs, massage, cupping, diet and other modalities. Chinese herbs are always used in a formula, you need two or more herbs. There are hundreds of herbs, they’re combined and matched in different ways to create different formulas. Diet is a big part of Chinese medicine, they have very particular ideas on diets and how diet can affect different body types and different diseases.

Acupuncture

Acupuncture is among the oldest healing practices in the world, dating back 2500 years, and has been refined and improved over that period. There are different styles of acupuncture, including Chinese, Korean, and Japanese. In Chinese medicine, there are 14 primary channels, sometimes called meridians, that span the body. There are three on the inside of the arm, three on the outside of the arm, and then three on the inside of the leg, and three on the outside of the leg, there’s also one that goes down the midline in the front and one that goes down the midline on the back. They’re all connected, it’s more useful to think about them as a grid that spans the whole body. Like in Western medicine, they healthily help the body function, but from a Chinese medicine perspective, some organs have functioned similarly to our scientific understanding of organs, but some are unique to Chinese medicine.

Each of the organs has a different relationship with each of the other organs, and these relationships are what keep the balance in the overall system. The goal of Chinese medicine is to find balance, so you can be healthy. Too much or too little of something can throw the system out of balance, and that’s when you’ll experience unhealthy symptoms. This imbalance leads to a blockage in the flow of Qi (chi) along the channels and meridians, and you can be unblocked according to Chinese medicine by using acupuncture at certain points along these channels.

The Yin and Yang can be sewn as a part of a continuum, a sort of spectrum that goes back and forth. The hot and cold is also a part of Yin and Yang, but we also look for signs of heat and cold in the body, which can help determine the course of treatment. Qi is another big subject related to the previous two, it’s the body’s energy, and we want the right amount of it to maintain good health.

An acupuncturist will try to diagnose your particular condition, they will ask about symptoms you’re experiencing, your overall health and your lifestyle, they will look at your tongue and feel the pulse on both arms, both the tongue and the pulse can give information about the organs and general health. Many acupuncturists will palpate the body along the channels to give them an idea of where to insert the needles, they are looking for patterns of symptoms which then give a diagnosis on which they can base a treatment. In Chinese medicine, it’s all about the pattern of a person. Then treating based on that pattern when the needles are inserted, they’re typically retained for 20 to 30 minutes, maybe more. The needles are thin pieces of metal, they’re solid, they are so thin that dozens of them could fit into a syringe or a hypodermic needle, they’re completely sterile, they are used only once, and then they’re disposed of. They are perfectly safe assuming you have a qualified acupuncturist using them. When a needle is inserted, you may feel pressure at the point, and you may feel a hot or cold sensation, if any of the needles are uncomfortable, you can tell your acupuncturist, and they can change it. It’s all about communication, sometimes you might feel uncomfortable for just a moment, but you can quickly adjust to it. It’s a very relaxing and pleasant process.

Acupuncture & fertility

Chinese medicine has been used for thousands of years for women’s health care and fertility. Depending on what the issue is, Chinese medicine can treat many of the causes of infertility, but not necessarily if there’s a physical blockage. In Chinese medicine, the first rule is that we try to regulate the cycle if it’s irregular if the cycle is too short or too long if the period is too heavy or too light if they’re spotting before the period or if ovulation if there are premenstrual symptoms, etc.

Acupuncture will have a particular treatment during the follicular phase, a different one in the ovulation phase and another during the luteal phase. Any underlying medical conditions that the patient has been diagnosed with, such as thyroid issues, uterine fibroids, endometriosis, and PCOS, although the last two can be a little more difficult with Chinese medicine, can be treated. If part of the issue with a couple’s fertility is with the man, then he should also seek out an acupuncturist who will treat him with the hopes of increasing sperm quality and motility. Stress is a factor in male infertility, the acupuncture affects endogenous opioids and neurotransmitters, serotonin and dopamine. Acupuncture treatments over time can help reduce stress levels by sort of igniting the opioids and the neurotransmitters. Male infertility and acupuncture have not been studied much, but some small studies show positive results, however much more is needed to confirm these results.

Acupuncture also regulates uterine and ovarian blood flow, which leads to a thicker uterine wall, so fertility is improved through embryo implantation being more successful. It can also impact beta-endorphin levels and thus hypothalamic function, which affects the gonadotropin-releasing hormone secretion in the menstrual cycle. It can affect neurotransmitters, serotonin and dopamine, which also lead to analgesia sedation and to the recovery of motor function, which can also help with menstrual pain.

Acupuncture has been shown to decrease blood sugar levels and decrease insulin resistance, which can be particularly useful in PCOS, so overall, with acupuncture, it’s possible to regulate the hormones, increase uterine and ovarian blood flow, decrease stress and treat other underlying conditions that may affect fertility.

Acupuncture & IVF

There have been very positive studies and meta-studies that show increases in success for patients that do a before and after treatment on the day of embryo transfer, particularly women with a lower chance of success, women that have not previously succeeded with IVF and women over the age of 36. There are a handful of studies that say it doesn’t help, or they say, it doesn’t, but it says that the results aren’t distinguishable from sham acupuncture. However, keep in mind that, first of all, different studies use different acupuncture points, so that could be an issue. Second, in different studies, various methodologies are used and sometimes, in studies, non-acupuncturists are used to insert the needles.

We know that acupuncture does reduce stress, IVF can be a very stressful process, the process as a whole can be stressful for couples, and then if you’re travelling abroad for the treatment, it can become even more stressful. There’s one great study that was just looking at stress and acupuncture and IVF, and that very clearly showed that women were much less stressed out and had a more positive outlook during the process when they were undergoing acupuncture.

What is the ideal amount of acupuncture sessions? There’s no consensus on the optimal treatments needed. It’s different for different people. The majority of women doing acupuncture with IVF will only have the acupuncture on the day of embryo transfer. However, there is good evidence to show this increases success. There’s one great study that showed improved odds of successful treatments starting 3 months before suppression, so that would be 12 or more treatments before 3 months, this is probably ideal. These things need to be studied more, we don’t have the exact number of treatments, but it’s best to go for those 12 treatments to give yourself the best chance of success.