Even though it may seem like a new trend to the modern fertility patient, the use of the Chinese healing art of acupuncture to treat fertility is one that can be dated back at least two thousand years. A lot of my patients are curious about the “tools of the trade,” because like a modern doctor, I do use an array of therapeutic instruments to treat my patients. The tools I use to help restore my patient’s fertility may not require as much electricity as an RE’s, but since they have been passed down and perfected over a couple thousand years, I would definitey argue that they are pretty state-of-the-art.
You may have heard that one of the most important concepts of Chinese medicine for fertility (or any other illness/symptom) is that of natural balance. When proper balance of energy exists, the body has acheived a healthy circulation of qi, or life force. Qi flows throughout the body along channels called “meridians”. When the flow of qi is insufficient, unbalanced, or interrupted, illness may occur. Acupuncture is the insertion of very fine needles (sometimes in combination with electrical stimulus or with heat produced by burning specific herbs called Moxibustion – more about this later) into the skin at specific acupuncture points in order to influence the functioning of the body. The choice of acupuncture points varies from patient to patient and treatment to treatment and relies on very careful diagnosis of different kinds (another topic!).
Let us first discuss the acupuncture needle. The earliest primitive acupuncture instrument used in ancient China was the “stone needle” (ouch!). This eventually developed into what is called “the nine needles” made of metal. The nine needles were used for various depths of entry into the body and were of different shapes and sizes: sharpened, round, elongated and miniature. With the advance of manufacturing technology, acupuncture needles are being made with greater and greater precision. Modern acupuncure needles are about the thickness of a hair brush wire and are designed to be virtually painless upon insertion. The needles modern TCM practitioners use are single-use and sterile.
Today, like the acupuncturists of two thousand years ago, the acupuncture needle is used by the practitioner to unblock energy flow in order to restore health or reduce pain. For example, the acupuncturist can move stagnation to relieve painful pms symptoms. The needles are also used for supplementing various deficiencies; to treat a woman who has missed a period due to blood deficiency, for example. Lastly, the needles can also be used to drain an excess which is creating imbalance as in the case of a woman who experiences extra-long periods and may have excess heat in the blood.
So now you know a bit more about acupuncture and needles. Stay tuned for the next chapter of “Tools of the TCM Trade.” Please feel free to comment with any questions you may have about acupuncture and the treatment of infertility.
To book an initial fertility acupuncture consultation with Pamela at our Arlington Heights office, click here .
You may have read my recent post about an Ann Arbor study* that found electro-acupuncture, in conjunction with Traditional Chinese Medicine pattern diagnosis, achieved IVF success rates double that of the national average. Because the results of this study are so striking, we wanted to take a closer look.
What makes this study interesting is that it adheres to a main tenet of Traditional Chinese Medicine – that treatment is individualized according to a patient’s specific diagnosis, rather than a standardized protocol. In this study, acupuncture points, chosen according to a patient’s traditional Chinese medicine pattern , were combined with electro-acupuncture and the researchers found the likelihood of a conception was greatly improved.
The study compared three different groups of acupuncture patients all going through a typical medicated IVF cycle. The first group was a traditional Chinese acupuncture (TCA) group, which used selective points based on the individual’s presenting pattern. There were five different Chinese medical diagnostic patterns recognized and three to five points were selected for treatment based on each patient’s specific pattern. The second group used electro-acupuncture (EA) based off of points used in a previous Swedish study done by Stener-Victorin et al which was published in Human Reproduction**. The third group used a combination of both TCA and EA. Acupuncture intervention for all groups consisted of a minimum of 12 treatments, two per week, prior to embryo transfer.
The frequency of treatment in this study is higher than many other studies (including the Sterner-Victorin study which used 8 sessions) looking at acupuncture and IVF. Patients had a minimum of 12 sessions (2 per week) prior to transfer and about half of the patients had more than 13 treatments. All groups had IVF conception rates higher than the national average, but it was the third group that had the best outcome with an 81% success rate. The first group (TCA only) had a 64% success rate and the second group (EA only) had a 63% success rate.
Now, in case you’re a bit freaked out by the term “electro-acupuncture,” I’d like to take a moment to dispel your fears. Electro-acupuncture is a technique where a TENS (transcutaneous electrical nerve stimulation) machine is attached with small clips directly to acupuncture needles. When electricity is applied to the needles, the sensation is that of a light tapping. Some patients have even asked me if I’m tapping them with my finger when I’ve used EA on them, but I’m not, that’s simply the sensation caused by the TENS machine. It’s a comfortable feeling that is kept constant during the entire treatment session. By stimulating the points we are further enhancing their function, thereby intensifying the effect of treatment.
These results from the Ann Arbor study show the importance of using a differential traditional Chinese medicine diagnosis with the benefit of the added stimulation from the electro-acupuncture. I have seen this to be true empirically in my fertility practice so when this study came out it was especially exciting to see that it affirms my practical experience.
Please feel free post your comments and questions!
Endometriosis is a condition where cells similar to those that make up the lining of the uterus grow in places where they have no business showing up – like the ovaries, bowel and bladder, and even the muscular tissue of vagina. Like their relatives in the uterus, these rogue upstarts (called implants) respond to the hormonal cues of the menstrual cycle, first getting thicker and then breaking down to “bleed.” But unlike the endometrial lining of the uterus, the implants have nowhere to flow and as a result may form into painful scar tissue or fluid-filled lesions – ouch!
Pelvic pain (sometimes severe!) at the time of menstruation and/or ovulation is the most common symptom of endometriosis, and secondary symptoms may include abnormally heavy periods and infertility. If you are under the care of a physician for endometriosis, treatment can include birth control pills, other hormonal medications and in advanced cases, laparoscopy to remove scar tissue and implants.
Endometriosis is challenging under any circumstances, but managing endometriosis while you’re trying to conceive adds an entirely new level of complexity. Obviously, when you’re trying to conceive, using birth control pills and hormone treatment becomes trickier. Nevertheless, don’t despair. Your OB or Reproductive Endocrinologist will counsel you on how best to treat your endometriosis in preparation for ART (Assisted Reproductive Technology). In addition, the following holistic practices can help you manage pain and stress, as well as support your reproductive system in preparation for a successful pregnancy.
1. Eat an anti-inflammatory/gut-friendly diet
The pain associated with endometriosis is thought to be in part due to inflammation caused by higher levels of “bad prostaglandins.” Prostaglandins are chemical messengers produced in every cell in the body. These chemicals have some beneficial effects (enhance immune function, increase blood flow, block inflammation) and some problematic effects (promote inflammation, decrease blood flow, contract muscles and produce pain). Unfortunately, research shows that women with endometriosis produce higher than normal levels of the second guys, pro-inflammatory prostaglandins (1), as well as higher levels of oxidative stress ( click here to read more about oxidative stress and fertility ) (2).
Certain foods can increase levels of inflammation in the body. For that reason, women with endometriosis can benefit from limiting pro-inflammatory foods like red meat, omega-6 oils and refined sugars. Other foods, including healthy oils and anti-oxidant rich fruits and vegetables can help reduce inflammation. Promoting good digestion is also key. Endometrial implants can occur in the gut and pelvic pain is often exacerbated by poor digestion. At Pulling Down the Moon we recommend that women with endometriosis adopt an ultra-healing diet like our ART Recovery/Prep Program. This eating program is designed to decrease dietary sources of inflammation and promote gut health.
2. Stress Reduction
Interestingly, studies show that women with endometriosis suffer from depression at a higher rate than their fertile counterparts. (2). In addition, levels of the stress hormone cortisol are higher in the follicular fluid of women with endometriosis vs. fertile women (3). Since stress and depression have been shown to negatively impact a woman’s ability to conceive, relaxation training and finding emotional support can play an important of healing endometriosis. (4) Taking a yoga class, joining a support group or learning basic relaxation techniques are all good strategies for women with endometriosis.
3. Acupuncture/Traditional Chinese Medicine
Traditional Chinese Medicine (TCM) treats endometriosis in much the same way that it treats any disorder – as a symptom of underlying imbalance that can be treated with acupuncture, herbal therapy and lifestyle changes. While no specific studies exist looking at endometriosis, TCM and fertility, there is a growing body of evidence that TCM can help with the pain and dysmenorrheal that many women with endo experience (5). In addition, it is well established that TCM helps treat stress and depression.
Many women don’t realize the potential healing benefit of massage for endometriosis. Studies have shown that mechanical manipulation (stretching and pulling) on body tissue can release and potentially break down scar tissue (7). Touch therapy also helps to elevate mood and reduce stress and release tight musculature that contributes to pelvic pain. A fertility massage like our FEM protocol session “Enhance the Blood” that focuses on deep work in the pelvis and improving blood and fluid flow in lower abdomen can be extremely beneficial for women with endometriosis – even when not trying to conceive.
The take-home message here is if you’re struggling with endometriosis, you can still feel very optimistic about your odds of conceiving. A combination of excellent medical care and lifestyle changes can drastically impact your symptoms and put parenthood in your sights. For more information or for help building your holistic self-care strategy, contact Pulling Down the Moon at 312-321-0004 (Chicago) or 301-610-7755 (Shady Grove, MD) for a complimentary Patient Advocate session or visit our website at www.pullingdownthemoon.com .
- Lee J. Selective blockade of prostaglandin E2 receptor EP2 and EP4 signaling inhibits proliferation of human endometriotic epithelial cells and stromal cells through distinct cell cycle arrest. Fertil Steril. 2010 Mar 5. [Epub ahead of print].
- Ngo C. Reactive oxygen species controls endometriosis progression. Am J Pathol. 2009 Jul;175(1):225-34. Epub 2009 Jun 4.
- Danielle L. Depression: an emotional obstacle to seeking medical advice for infertility. FertileSteril. 2010 Jan 2. [Epub ahead of print]
- Oehmke F . Impact of endometriosis on quality of life: a pilot study. Gynecol Endocrinol. 2009 Nov;25(11):722-5.
- Volgsten H. Personality traits associated with depressive and anxiety disorders in infertile women and men undergoing in vitro fertilization treatment. Acta Obstet Gynecol Scand. 2010;89(1):27-34
- Wayne P. Japanese-style acupuncture for endometriosis-related pelvic pain in adolescents and young women: results of a randomized sham-controlled trial. J Pediatr Adolesc Gynecol. 2008 Oct;21(5):247-57.
- Langevin H. Dynamic fibroblast cytoskeletal response to subcutaneous tissue stretch ex vivo and in vivo. Am J Physiol Cell Physiol. 2005 Mar;288(3):C747-56. Epub 2004 Oct 20
Have you ever had a week where a single idea pops up at you from a million directions at once? In my life this week the theme that started to emerge was transition . It cropped up in yoga classes, in conversation with friends, even at Pulling Down the Moon as we adapt to our cool new website and e-commerce system. Transition is also all around outside. In Chicago the mountains of winter snow outside my door are melting – revealing the shoots of tulips already breaking through the earth. Of course, as a yogi, I believe that the themes emerging in my outer life contain clues to my inner life. So when I went to my yoga mat this week, I meditated on transition.
At Pulling Down the Moon our fertility yoga practice is a style of yoga called vinyasa, a flowing series of postures. As I practiced this week I turned my attention to the transition between the postures rather than the postures themselves. What I found was fascinating. Moving from one pose to another with awareness was much harder than moving without awareness. Between each pose I discovered an infinite number of experiences of breath, balance, strength and mastery.
Finishing that week of practice, I had what we call a “yoga insight” (or satori, in Sanskrit). Transition is the place where life is actually happening! Each ”finished” pose is gone – belongs to the past – and each “future pose” is fantasy – belonging to an idealized future. Yet in the middle, where the pose is emerging and awareness is shaping each moment, life and joy are always present.
Infertility is a transition, too. We are moving from our previous childless existance toward parenthood. It’s easy to reject what has come before and race toward the future. Yet in doing so we deny our own life and existance as valid. This week we challenge you to exist in the transition, the now, of your life. It’s in this moment that you can feel your own strength and beauty, your own courage and the exquisite creation of life.
Women and couples who are trying to conceive often experience loss and disappointment. Pulling Down the Moon’s Dealing with Disappointment program offers patients an opportunity to come together in community and share those losses in a supportive environment.
Check out our video for more information about this program which happens quarterly. This month, the program will be held on Monday, February 7 at our Chicago River Walk location. Click here to register.
A recent study entitled “Acupuncture as an Adjunct to In Vitro Fertilization: A Randomized Trial” was published in the journal Medical Acupuncture showing that electro-acupuncture used in conjunction with Traditional Chinese Acupuncture doubled the pregnancy success rates of IVF patients as compared to the national average of patients undergoing IVF.* The study was conducted at Acupuncture and Chinese Medical Center in Ann Arbor Michigan using a total of 52 IVF patients with the average age of 38 years. The patients in the study were randomly divided into three different groups: 1) traditional Chinese acupuncture (TCA) plus electro-acupuncture (EA), 2) TCA-only, or 3) EA-only. All patients also underwent “standard IVF medication regimen.” The authors of this study did not include an IVF-only control group and compared their treatment outcomes to average U.S. IVF success rates.
According to the Center for Disease Control and Prevention the average success rate of IVF alone is about 40%. In this study all groups had higher IVF success rates than the average U.S. success rate, and the improvement was greatest when TCA and EA were used in conjunction. The authors conclude a “marked increase with the combination of TCA and EA (81.8% success rate)”!* The TCA alone group had a 64% success rate, and the EA alone group had a 63% success rate. The points used in the TCA and EA group were determined based upon the patient’s individual traditional Chinese medical diagnosis. This study proves that traditional Chinese acupuncture in combination with electro-acupuncture “…is a promising new technique for the treatment of infertility with a higher IVF success rate than that of TCA or EA alone.”*
While this study would have been strengthened by the addition of an IVF-only control group, the findings of this study are supportive of the growing body of evidence that treatment with Traditional Chinese Acupuncture does increase a woman’s chances of conception with IVF.
*Medical Acupuncture Volume 21, Number 3, 2009 “Acupuncture as An Adjunct to In Vitro Fertilization: A Randomized Trial”
If you build it, they will come. Co-Founders Beth Heller and Tami Quinn share their story on why they decided to create Pulling Down the Moon.
Fish oil with Omega-3s (that supply DHA and EPA) are a class of supplements commonly recommended for women with infertility. While nutritionists stress the importance of quality when choosing supplements, many people buy fish oil from their local store for convenience or to save money. This past week a lawsuit was filed in California against fish oil manufacturers [CVS Pharmacy Inc.; General Nutrition Corp. (GNC); Now Health Group Inc.; Omega Protein Inc.; Pharmavite LLC (Nature Made brand); Rite Aid Corp.; Solgar Inc., and TwinLab Corp]. The lawsuit charges that these companies sold fish oil that contained “undisclosed and unnecessarily high levels of contamination with polycholorinated biphenyl (PCB) compounds.”
What are PCBs? PCBs are a class of chemicals that are now illegal. However, they were utilized for many different purposes in industrial manufacturing – such as in coolants, PVC piping, pesticides and paints among other things. They are now considered one of the POPs (Persistent Organic Pollutants), a group of the most toxic compounds that still exist in our food and bodies despite being outlawed years ago. According to the EPA, PCBs have been shown to cause cancer in animals, and negatively affect the immune system, reproductive system, nervous system, and endocrine system, amongst other ill health effects. Here is an excerpt from the EPA’s website about the effect of PCBs on reproduction in animals and humans:
“PCB exposures were found to reduce the birth weight, conception rates and live birth rates of monkeys and other species and PCB exposure reduced sperm counts in rats. Effects in monkeys were long-lasting and were observed long after the dosing with PCBs occurred.
Studies of reproductive effects have also been carried out in human populations exposed to PCBs. Children born to women who worked with PCBs in factories showed decreased birth weight and a significant decrease in gestational age with increasing exposures to PCBs. Studies in fishing populations believed to have high exposures to PCBs also suggest similar decreases. This same effect was seen in multiple species of animals exposed to PCBs, and suggests that reproductive effects may be important in humans following exposures to PCBs.”
According to the Environmental Working Group, one of the highest food sources of PCBs include farm-raised (or Atlantic Salmon), with 16 times the amount of PCBs as wild salmon. Thus, supplementing your diet with a fish oil that contains PCBs or eating farm-raised salmon to obtain omega-3s may do more harm than good. It’s important to know where your supplements (and food) are sourced from, and how the companies treat and process it to form a supplement. There are many companies that sell high-quality fish oil. Read more about the quality of our fish oil here . Please consult with a Pulling Down the Moon nutritionist if you have more questions concerning this matter.
For more information:
Here’s a good new/bad news situation. The bad news is that more women are likely to receive a diagnosis of Gestational Diabetes Mellitus (GDM) in the coming months. The good news is that if you’re in the trying to conceive process and eating a fertility-friendly diet like the one we use at Pulling Down the Moon you are well on your way to preventing this condition which can be dangerous to mother and baby.
Previously, a diagnosis of GDM was based on blood sugar measurements that identified women at higher risk for developing diabetes later in life. The new standards take into consideration risks to the mother and baby, including overweight babies, early delivery, c-section delivery and pre-eclampsia (a life threatening rise in blood pressure that endagers health of mom and baby). When these outcomes were added to the equation, experts found they needed to make the diagnostic criteria more stringent. With the new guidelines, it’s estimated 16% of pregnant women will be found to have GDM instead of the 4-6% who currently get diagnosed.
Just in case you needed a bit more motivation to either get started or keep going with your fertility-friendly diet, do it for diabetes prevention and the health of your future child!
The most recent issue of Body Sense Magazine features Pulling Down the Moon’s Massage Director Meredith Nathan on the topic of how massage can help you lose weight. When we asked Meredith about this topic, she came up with three ways massage helps us meet our weight loss goals right off the bat:
1. Massage lowers stress hormone levels. Stress hormones like cortisol can increase our appetite, especially for sweet foods, and make our body more prone to gain weight around the middle. Reducing stress reduces “stress eating” and mindless munching.
2. Massage helps to release the aches, pains and to heal chronic injuries so we are more apt to get up and move our bodies.
3. For those of us who like to treat ourselves for good work and good behavior, massage is calorie free and ultimately makes us feel better about a job well done than a hot fudge sundae.
So, if you’re struggling to attain/maintain a your fertile weight, massage may be the missing link! Click here to read more about what the experts have to say…
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