Does acupuncture really help improve IVF outcomes?

The latest review of evidence is out and yes the results are clear. It seems it has been missed by many as it was published in the holidays on the 2nd January 2019!

This is considered the most up to date evidence from a systematic review and meta-analysis and should help to clarify the benefits and rectify the recent misunderstanding from a study published in 2018 that put the use of acupuncture under question.

If you are interested to read the research in full, follow the link to the review and jump to the discussion section for details on effectiveness.

Here is the link: “Acupuncture performed around the time of embryo transfer: a systematic review and meta-analysis”  Smith, Caroline A. et al. Reproductive BioMedicine Online, Volume 38 , Issue 3 , 364 – 379

In this review of all of the latest and relevant evidence from English speaking publications, Smith concludes that:

  • Acupuncture with IVF may have potentially significant benefits when compared to IVF only in regard to both clinical pregnancy AND live birth rates.
  • Acupuncture seems most effective when there are more treatments (higher dose) than just pre and posttransfer acupuncture – especially with treatment in both the stimulation and implantation phase.
  • Further benefits are seen when points selected are tailored to the individual rather than using a pre-prescribed treatment protocol.
  • Benefits are especially true for women who have had multiple previous IVF cycles.

What has been confusing in recent research and discussed in this review is that when acupuncture is compared to sham acupuncture as the control, the benefits are not seen for acupuncture over sham acupuncture. Rather than negating the effects of acupuncture (which seem clearly beneficial), this begs further questions about the placebo effect of acupuncture and/or the validity of sham acupuncture – these devices or points used may not be inert after all and have some effect.

It seems acupuncture is in fact considered effective when compared to IVF alone and worth pursuing for IVF patients.

Smith also mentions how acupuncture may be working via the stress relieving and psychosocial benefits with a significant anxiolytic effect reported and potential beneficial effects such as increase in uterine blood flow, endogenous endorphins and cytokines. The non-needling benefits of acupuncture treatment (the holistic nature of a consultation with palpation, education, self-care and diagnosis etc) are discussed too.

Smith further states that acupuncture remains a low-risk intervention.

While it is so good to read this validation of the use of acupuncture during IVF, for us, although our patients having a take home baby is obviously a key desired outcome, benefits of treatment are not only about the pregnancy and live birth rates. Reduced anxiety levels and a better ability to cope with infertility and IVF is so important for people with poor outcomes, fragile emotional health, and those doing back to back cycles who need to ‘gear up again’ after a negative result. This effect cannot be underestimated. Sometimes it can be the difference between patients feeling like they have the internal resources to take on the next cycle, or need a break. Regular acupuncture with practitioners skilled in working with IVF patients can provide support they need to navigate their experience as seamlessly as possible, potentially with fewer side effects and positive outcomes more quickly.

We continue to offer acupuncture services to support IVF patients at Fertile Ground Health Group as a 1:1 appointment or in our multi-bed facility which works really well for the flexibility of fitting IVF transfer patients in on the day when they find out their transfer times.

We generally recommend patients come in at least once before the transfer as the follicles are stimulated, one to two times on the day of transfer, and another around five to seven days after transfer for implantation support.

Even more ideally where possible and time permitting, we recommend weekly appointments in the two to three cycles leading up to IVF.

Hope you find this helpful. If you are considering booking in. you can see our practitioner profiles here or go straight to our online booking page here.

Please help us share this information to anyone you know involved with IVF as a specialist, practitioner or patient to ensure they know about choices available for appropriate supportive treatments.

Our acupuncture team is more than happy to write or speak about this new systematic review and meta-analysis to IVF and fertility groups too. Please be in touch if you have an opportunity for us to be involved in spreading the word about this.

CharmaineDENNISC

 

Charmaine Dennis is the founding director of Fertile Ground Health Group and has been practicing naturopathic fertility and preconception health care for nearly 20 years. She is passionate about collaborative health care and ensuring that people going through IVF are given accurate information about all the many ways IVF outcomes can be improved with lifestyle and complementary medicine interventions.

 

 

Beautiful times through pregnancy to see your Acupuncturist

Pregnancy can be so demanding on the body.

Physically and emotionally.

Acupuncture can be Oh So Useful in pregnancy.

As an Acupuncturist I often get asked – when are the most delicious times to check in with your Acupuncturist?

So let’s jump in.

 

Regularly though the first twelve weeks

Especially if it’s taken some time to conceive this babe, you’ve experienced pregnancy loss in the past, or you’re feeling particularly anxious about this pregnancy.

Also, if symptoms like nausea and fatigue are having a considerable impact, give your Acupuncturist a call. And the sooner the better on this one.

 

Through the middle of the pregnancy: as symptoms arise

And again, the sooner the better on this one. Catch things like carpal tunnel, back pain, insomnia and indigestion as they arise.

An alternative to the ‘catch things as soon as they creep in’ approach is to schedule monthly check in appointments with your Acupuncturist through the middle of the pregnancy. There is always work to do. And a month can be a very long time during pregnancy!

Go with what you feel will work best for you.

 

Weekly in the final weeks of pregnancy

Weekly from 37 weeks is ideal. This will help facilitate the smooth preparation of bringing this divine soul earthside and prepare your body for labour.

There is so much divine work going on inside your body during this time. Many women become physically more tired and sore. And it may become harder to reach good pockets of sleep.

On top of that, there can be car seats to fit, renovations to finish (why does that always happen?!), and an influx of information coming at you from your birth provider.

There’s the endless thoughts of what labour is going to be like. How we are going to work with the pain.

In other words, there is A Lot. And our minds at this time can go into overdrive.

As the To Do List can whir around us, it’s time to breathe and come home.

A space that Acupuncture is so great at facilitating.

 

More often if you pass your estimated due date

Great to book in some treatments for 40.5 weeks and even 41 weeks. It’s very common to reach these! An estimated due date is just that, an estimate.

So if you do become ‘overdue’, lets use the pins to create some calm space, and facilitate the most optimal environment for your body to go into labour.

 

On ‘the other side’

If you’re seeing an Acupuncturist, ask them what to do regarding treatment on ‘the other side’.

Once pregnancy has drawn to a close, the summit of labour has been climbed, and you have that sweet delicious soul in your arms, there may still very well be work to be done.

Stepping over the threshold from pregnancy to motherhood does not mean you no longer require support.

In general, Chinese Medicine advises that it’s absolutely best for mum and babe to stay indoors and rest for the first 6 weeks. To get to know each other, facilitate recovery from the big experience of birth, and sync up in their rhythms.

At the same time, be in contact with your Acupuncturist if any bumps arise. They may be able to help you. Or they may be able to guide you towards the correct support you may require. Early intervention can be so useful with many postpartum conditions, so please remember that it is always, always okay to ask for help.

 

AmyObrienColourAmy O’Brien is a registered Acupuncturist and Chinese Medicine practitioner with a passion for preconception, fertility and pregnancy care. Amy has extensive experience in acupuncture, including a 2 year period of administering acupuncture in a Melbourne hospital. She enjoys working with every aspect of health and disease to assist you in creating fabulous health.

How is acupuncture going to help me conceive?

by Naomi Jankowski, FGHG Acupuncturist

The question I receive the most frequently in clinic is ‘How does acupuncture work?’ This is such a fantastic question with multifaceted answers. The question I like even better is ‘How is acupuncture going to help me conceive?’ When I consider this, there are two parts to the answer which are relatively easy to explain, and which are very important for patients to hear so they understand what we are doing, rather than just going along with a bunch of arbitrary needles.

The first part of this relates more broadly to the question of how acupuncture works. Through my experience in clinic, I have found that so much of acupuncture works on benefiting blood flow and circulation.  Acupuncture does not just work by bringing blood flow to the area where the needle is inserted, in fact often the needles selected will direct the blood flow to an entirely different area of the body.  For example, I routinely use points on the hands that have a direct affinity to the ovaries and uterus.  If a patient comes to see me on a day that they have menstrual cramping, using these points on the hands usually decreases the pain within a few minutes.  By facilitating blood flow to the area, the uterus is then able to function more efficiently.

In many cases, menstrual cramping is caused by a small amount of uterine clotting that is stuck.  The cramps occur when the uterus has small contractions to try to push the clots out.  Unfortunately, the contractions often become inefficient, and then we have the problem which we so often see in clinic, where a woman either has pain or heavy bleeding.  Increasing the blood flow to the uterus facilitates more efficient uterine contractions.  This in turn will decrease pain, decrease heavy bleeding, and, most importantly, create a good basis of endometrial lining.

This brings us to the next point, and our next question of ‘How is acupuncture going to help me conceive?’ Patients often tell me they have low AMH, and that their fertility specialist has told them they cannot conceive as a result of poor egg quality.  Egg quality is certainly part of the picture, and cannot be overlooked.  But let’s consider another perspective.  What good is the perfect egg if the quality of the endometrial lining is so poor that implantation cannot occur?

The analogy of soil works best to illustrate this point.  A seed will not be able to form roots in soil that is littered with rocks, debris and clumped up dirt.  No matter how much fertilizer you add, if there are enough rocks in the soil, your seed will not grow.  These rocks are the clots in the endometrial lining.  First and foremost, our job is to help eliminate this clotting.  Secondly, we work to add fertilizer to the soil i.e. thicken the endometrial lining.  Then, if necessary, we work on egg quality.  Often I never need to directly work on step three, because by that time, conception has successfully occurred.

It is important to note here that patients often have their lining measured, and are told that it looks fine.  This is a measurement in millimeters that does not take into account quality of lining and possible clotting.  Clots will, in a sense, artificially increase the ‘true’ lining of the uterus present on the scan.  It is detrimental lining that leads to a false reading in millimeters.

So to summarize and answer these clinically relevant questions, the benefit of traditional Chinese gynecology is that it takes into account the quality of the endometrial lining.  Acupuncture can facilitate blood flow to the uterus, to improve the quality of this lining which increases the ability of an embryo to implant.

NaomiJANKOWSKIColourNaomi Jankowski is a highly experienced, registered acupuncturist and Chinese herbal medicine practitioner. Naomi is known for her ability to build relationships with her patients where they feel truly supported supported, even the most difficult of fertility and reproductive journeys.

Pregnancy Acupuncture 101

Ashley Gordon, FGHG Acupuncturist takes us through the basics of acupuncture during pregnancy and explains why it’s such a good idea.

Is it your first pregnancy? Maybe your second or third? Whichever is the case, when you are looking for pregnancy advice, if you Google it you will be inundated with pages of links and information overload. If you don’t have time to navigate the extensive library of information, here is a short spiel on pregnancy acupuncture, the best bits, to save you some time!

I’ve had many questions asked of me about acupuncture, but undoubtedly the most common is “Does it hurt?” and specifically for pregnancy acupuncture, “Is it safe?” The answer to the second question is YES, it is safe! The first question, is a bit more troublesome as it is based on an individual’s pain tolerance, which is subjective, but in general acupuncture doesn’t hurt. Sure, we are puncturing the skin with a needle, so there has to be an initial prick, but there should be no unwanted sensations after that. Some patients even fall asleep, or use the time to meditate while the needles are doing all the hard work for you!

The next most common question is “Is pregnancy acupuncture beneficial?” During the first trimester, it’s very commonly used to treat and alleviate symptoms such as nauseaheartburn and fatigue. Acupuncture aims to maintain health and restore balance within the energy flow of the body – this is crucial due to the multitude of amazing changes that occur during pregnancy. Not only do we need to give the body some credit for the incredible task it has ahead of it, but also give you as much assistance as we can to help the pregnancy move forward with ease and grace.

Equally as important as the first trimester is the third trimester. This time can be used to prepare the body for labour. This is all about blood flow, ensuring the body is well nourished and all of the key organs active in labour are supported and regulated – this is what is called birth preparation acupuncture.

But why is birth preparation acupuncture important, you ask?

Think of it as training. Would you front up to a marathon without any training? Probably not. The #1 reason for birth preparation treatments is to promote a smooth labour. Birth preparation acupuncture consists of a series of weekly treatments from 34-36 weeks onwards and can help to prepare the body for labour. Due to this preparation, your body will not be a stranger to acupuncture if used for labour promotion and will be more receptive to it’s effects. When the time arrives to assist in helping your baby engageincrease cervical ripening and dilation or strengthen contractions, acupuncture is here to help.

Here at Fertile Ground, not only do we have skilled acupuncturists, but we also have Naturopaths, massage therapists and Osteopaths to further assist you and your body throughout the incredible journey of pregnancy. It’s the wholistic approach that we love the most here at Fertile Ground and it would be our pleasure to help you on your way…

 

Ash Gordon colourAshley Gordon, FGHG Acupuncturist

Ashley is an experienced acupuncturist and Chinese herbalist who is passionate about utilising the innate healing qualities of the body in achieving the desired outcomes, be that in fertility, pregnancy or general health. He has developed a strong focus and passion for pregnancy, birth preparation and pre conception care, and is motivated by being apart of each individual journey and the emotional and physical changes of these experiences.

Who is Ashley Gordon, Acupuncturist?

We talk to Ashley Gordon, Acupuncturist at FGHG and discover what makes him such a fabulous, dedicated practitioner and why he has chosen to focus on reproductive health, fertility and pregnancy acupuncture.

What initially ignited your interest in studying to become a Traditional Chinese Medicine (TCM) practitioner and acupuncturist?

Before my time as a TCM practitioner, I was a middle school Biology and Maths teacher. This was good, but I knew there was something… I was on the prowl for job satisfaction. Whilst having a treatment from my acupuncturist, she said “you seem to know a lot about it, ever thought of studying it?”… baffled at the timing of that statement, my answer was “not until now…” and the rest was history!!

How does an Eastern philosophy differ from a western philosophy in terms of fertility and reproductive support?

In my understanding, as different as they can be, they are both just as crucial as the other. Simplistically and generally, Western philosophy seems to go by numbers… if they fit, then they are good. This may not always take into consideration factors such as stress, emotions, sleep and their related symptoms in the body… this is where Eastern philosophy comes in quite strongly. Together, they can make as awesome team, but each have their own ability to stand independently. Fertility and reproductive support can be so easily affected by so many different lifestyle choices. It make sense to sort these out ASAP!

What unique challenges and rewards come from working with your patients in an independent, non-Western healthcare care setting ?

The rewards are many. In fertility and reproductive support specifically, the answer is simply sharing in the joy of people succeeding in their goal of having a baby. In general, assisting people in working towards better health and maximising all that their body and life has to offer. The body knows, we just need to point it in the right direction sometimes…

Chinese Medicine is such a broad discipline with so many different tools, could you offer some insight into how Chinese Medicine works best for you as a practitioner and which areas you particularly love treating?

Without a doubt, my passion lies in treating pregnancy with acupuncture. My fascination and intrigue with the human body is epitomised by pregnancy. Watching the body, grow, adapt and mould whilst still supporting the day-to-day life of a human, blows me away. My other favourite is pre-conception care – assisting this miracle to happen is such a joy!

 

Ash-Gordon-colourAshley Gordon, FGHG Acupuncturist

Ashley is an experienced acupuncturist and Chinese herbalist who is passionate about utilising the innate healing qualities of the body in achieving the desired outcomes. Be that in fertility, pregnancy or general health.

Ashley has a strong focus on preconception care, pregnancy and birth preparation and is motivated by the journeys and emotional and physical changes that these experiences bring. It is his privilege to a be a part of such a personal and life-changing journey.

Getting to know your practitioner – Sonia Millett, FGHG acupuncturist

What inspired you to become an acupuncturist and Chinese Herbalist, with a special interest in fertility and pregnancy?

Fertility, pregnancy and women’s health conditions are some of the most interesting and complex to treat, for this reason it has always drawn me – there are so many interesting aspects to consider, such as hormonal and emotional factors.

I love the challenges fertility issues present, and in particular the joy of hard-fought successes such as conceiving a baby after years of trying.  I also enjoy then treating  patients up until they give birth –  there is a real sense of completion and connection with the patient.

I first experienced the benefits of Chinese Medicine when my infant son did not gain weight and was diagnosed with ‘failure to thrive’, and was very unsettled. Several pediatricians were unable to provide a reason or a solution. Chinese Medicine, however, provided some notable improvements, and I was hooked.

What do you see as the strengths that acupuncture and Chinese Medicine (CM) have to offer in terms of fertility and reproductive support?

Fertility and pregnancy treatments are a major area of strength in Chinese Medicine as it fills a gap in conventional Western Medicine. This makes it a wonderful adjunct to medical treatments such as IVF.  If a pathology is not visible (eg in scans/to the eye) or does not show up in testing such as blood tests, Chinese Medicine excels. This is why Chinese Medicine can be effective with diagnoses such as ‘unexplained’ infertility, or for older patients. Traditional Chinese Medicine has a different diagnostic system and we can find a diagnosis (and therefore help treat) even when there is none in Western Medicine.

Chinese Medicine practitioners treat the individual, not the disease, and aim to strengthen underlying issues in the body.  The treatments are more patient- centred.

Also, Chinese Medicine is a holistic approach, supporting the OVERALL health and vitality of the body, as well as treating health issues directly. The principle aim of Chinese Medicine and acupuncture is to recover the equilibrium between the physical and emotional aspects of an individual, by treating the whole person. This is why we also provide lifestyle and dietary advice, and consider the emotional state of patients.

Patients often report they feel less stressed and more able to cope following acupuncture treatments, and we see this as a vital part of the treatment.

In your work you assist a lot of women on their journey to becoming pregnant, do you recommend they continue to see you after they have fallen pregnant? What does acupuncture and Chinese medicine have to offer during pregnancy?

Chinese Medicine is very useful throughout pregnancy. It offers a gentle approach to treatment without side-effects. It can help treat conditions such as nausea in early pregnancy, and any pain throughout the pregnancy. In late pregnancy, acupuncture can be used to prepare the patient for an on-time labour.

The benefits of treatment also extend to post-partum for issues such as poor milk supply and for a boost in energy when exhausted.

Your week tends to be very busy, what sort of self-care do you do to recharge outside of seeing patients?

I get lots of benefit from connecting with special friends, and possibly combining this with a walk. Also a regular yoga practice. I find that any practice that nourishes you emotionally as well as physically, has more far-reaching benefits. Whenever time permits, I also enjoy  acupuncture, kinesiology or massage treatments throughout the year.

I enjoy massage treatments primarily for stress relief, and acupuncture or kinesiology when I have a more acute condition that needs addressing such as pain.  I personally really enjoy kinesiology – it’s an eclectic mix of treatment approaches (and even incorporates some Chinese Medicine channel theory).

What are your top five tips for others to help maintain a healthy lifestyle?

  • Eat a nutritious diet with primarily fresh fruit and vegetables (no need to eat low fat foods) and get daily exercise (doesn’t need to be strenuous).
  • Make time for fun and nurture the special relationships in your life. Particularly important when going through challenging times such as when trying to conceive or with a new baby.
  • Find Gratitude – notice things in your life daily that you are grateful for
  • Get plenty of sleep, ideally within the hours of 11pm – 6.00am.
  • And of course have regular therapeutic treatments such as acupuncture, massage, naturopathy, kinesiology, to maintain health – after all, prevention is better than cure! CM is great as a preventative to help keep you in peak heath and manage stress.

Learn more about Sonia Millet on our practitioner page here: Sonia Millet, FGHG Acupuncturist

Acupuncture IVF support after egg retrieval

Acupuncture has become a common modality used to support an IVF cycle. In recent years there has been a lot of excitement and extensive literature published about the use of acupuncture to support an embryo transfer and specifically, utilising it for pre and post transfer to reduce uterine contractions and spasms, as well as stress and anxiety [1]. There has also been more investigation into using acupuncture in preparation for starting an IVF cycle. These treatments usually begin 12 weeks prior to the IVF cycle and focus on stimulating blood flow to the uterus and the ovaries, to establish a healthy menstrual cycle and ovulation – with the benefit of having a healthy cycle to improve the outcome of IVF.

What many people are not aware of is an acupuncture IVF support treatment that deserves equal attention, with just as many benefits as pre and post embryo transfer acupuncture. That treatment is acupuncture to support recovery from the Egg Retrieval procedure.

Egg Retrieval or egg ‘pick up’ is a hospital day procedure where the eggs are collected from the ovaries and takes about 20-30 minutes under a general anaesthetic. During the procedure, your fertility specialist uses ultrasound to guide a needle into each ovary where the eggs are contained in a fluid within the follicles on your ovaries. The specialist removes fluid from the follicles that look like they’ve grown enough to have an egg inside. You will be in the recovery for about 30 minutes after the surgery and it is at this time the doctor or nurse will often tell you how many eggs they managed to retrieve.

Depending on many factors, the full recovery from egg ‘pick up’ can range from being quick, easy and painless, to a slower recovery and on rare occasions can be quite serious resulting with perhaps a stay in hospital.

The more severe and rare cases are often diagnosed with Ovarian Hyperstimulation Syndrome (OHSS).  Symptoms of OHSS includes rapid weight gain, severe abdominal pain, persistent nausea and vomiting, decreased urination, shortness of breath and enlarged and tight abdomen. Milder cases have more mild to moderate abdominal pain, abdominal bloating, nausea, diarrhoea and tenderness in the ovaries. If you are at risk of this, your IVF clinic will keep a close eye on you during your recovery period.

What is not so commonly talked about or written about, is the support that acupuncture can offer in recovering from an egg ‘pick up’. This is particularly important because the egg ‘pick up’ is done only part way through the IVF cycle. Your body still needs to receive and hopefully implant the embryo later in the IVF cycle.  Treating any swelling and discomfort after the egg pick up and before embryo transfer can be very beneficial.

During post egg pick up acupuncture sessions, we use acupuncture treatment to support circulation in the pelvic cavity, which is thought to bring healing cells and remove inflammatory cells in the region. The acupuncture needles are placed on the legs, arms and abdomen and many people find they feel the swelling go down instantly, after only 30 minutes with needles.

Along with using acupuncture in post egg retrieval, we always suggest some simple things like drinking plenty of water, eating lots of fibre and resting, whilst still getting some very gentle exercise like slow walking.

If you are going in for an egg retrieval and feel you might be at risk because you fit into one of the following categories:

  • have been diagnosed with PCOS,
  • have seen a large number of follicles on scans,
  • have a low body weight,
  • are under 30 years old or
  • have had previous OHSS.

We suggest organising an acupuncture treatment 1-3 days post the surgery. The good news is that if you are doing a fresh embryo transfer in that cycle, you can often combine the post egg pick up acupuncture with the pre- embryo transfer acupuncture to provide support for both procedures.

If you are seeing an acupuncturist and soon to do an egg retrieval it is worth asking them to suggest a plan for you around the time of the surgery. If you are not seeing an acupuncturist and feel that you could benefit from using acupuncture to recover from an impending egg retrieval, it is worth seeing a practitioner at least one week prior to the egg ‘pick up’ so they know your history and constitution and can guide you on the correct timing of treatments.

[1] Effect of acupuncture on symptoms of anxiety in women undergoing in vitro fertilisation: a prospective randomised controlled study https://www.ncbi.nlm.nih.gov/pubmed/20621276

 

Joanne SharkeyBy Joanne Sharkey, FGHG Acupuncturist

Joanne has been in clinical practice for more than 10 years. Her experience and knowledge make her a highly effective practitioner to support women and couples in starting a family. She individually tailors treatments, herbal, dietary & lifestyle advice for preconception care, health during pregnancy and birth preparation for a safe delivery. Joanne also has a special interest in treating PCOS holistically to regulate cycles as well as the hormonal side effects of PCOS including infertility

The next step in your Acupuncture career?

Are you our new Acupuncturist?

An exciting opportunity for an experienced acupuncturist / Chinese herbal medicine practitioner to join Fertile Ground Health Group is now available.

FGHG practitioners are leaders in their respective professions for IVF support, fertility and pregnancy related treatments and are well respected among medical specialists and experts within this area of practice. The launch of the new preconception bible (Create A Fertile Life) by the team at FGHG, along with moving to beautiful new premises and creating The Melbourne Apothecary, has seen huge growth for us in what evidently (and very sadly) has been a devastating year for many other practices and dispensaries.

We are ready to grow our team and we are looking for our next incredible Acupuncturist. To be eligible for this position you already have passion, confidence and experience in reproductive health, pre-conception care, infertility, IVF/ART, pregnancy, birth and beyond. Importantly, you also have a point of difference and love treating conditions or patient groups we don’t already have covered by our expert practitioners already.

Sound like a fantastic opportunity for you? Would you like to join us?

You will receive

You will have a fabulous, supportive team of well-known professionals to work, grow and collaborate with, along with a highly experienced business management and support team to guide, develop and expand your professional profile. You will have new patients waiting to see you and the established reputation of Fertile Ground Health Group to provide you with a consistent flow of patients to work with on an ongoing basis.

Is this you?

You value collaboration and your ability to develop referrer relationships and patient results are a must. You want to establish yourself as a leader in your profession and you are willing and ready to raise your profile through opportunities that excite you (or even scare you at least a little in all the juicy, good growth ways). You understand the value of writing blogs and social media, marketing contribution, networking, speaking opportunities (to health professionals or patient groups), running workshops, classes or support groups (in person, on zoom or on social media). The opportunities for growth within our team are endless, especially with your full access to all the foundational goods that come as part of the extensive springboard that is Fertile Ground Health Group.

What we’re looking for

We are looking for an experienced Chinese medicine practitioner who would like to simplify the work involved in running a business, who is ready to focus on being a fantastic and fully supported practitioner, dedicating efforts to growing patient reach and enhancing their profile and career with Fertile Ground Health Group.

Mentoring is also available for the right candidate if needed.

Practice session times

You will need to commit to a minimum of three sessions per week including alternate Saturdays. You will be working in one of Australia’s most intentionally beautiful and vibrant clinic spaces with an extensive dispensary supplying all of your prescription needs. We stock a Chinese raw herb, granule and pill dispensary and supply needles, moxa, and general equipment and other needs for practice. There is an extensive nutrition and western herbal dispensary available at The Melbourne Apothecary too.

What is The Melbourne Apothecary?

The Melbourne Apothecary has been created to provide Melbourne’s first prescription-only naturopathic dispensary, serving the FGHG team as well as filling prescriptions for Naturopaths all over Australia. The MA serves to protect the privacy of our fertility and IVF patients (for those who need it) along with opening up to the general health population as a street-frontage “shop”. It is a truly beautiful space and strives to be an example of what is possible.

Apply

To apply please email a cover letter and resume to Charmaine Dennis at charmaine@fertileground.com.au

Interviewing now

We will be interviewing as soon as the right candidates land in our inbox.

“Choose a job you love and you will never have to work a day in your life” Confucius

Pregnancy & Skin Changes

Pregnancy & Skin
Pregnancy & Skin – how are they related?

Pregnancy is an exciting journey, but may involve a set of new and frustrating skin challenges. The body undergoes a tremendous amount of change through pregnancy with more than 90% of women experiencing significant and complex skin changes. These changes may be desirable for some, but for others, pregnancy may trigger the onset or worsening of pigmentation, acne or eczema. 

Please understand that the tips included below are a general guide only. Each person requires individualised treatment as we’re all unique – so make sure you book in to get tailored advice before self prescribing as it may not suit your situation or health needs

Pigmentation

Hyperpigmentation (melasma) is one of the most common and early signs of pregnancy. High levels of Melanocyte Stimulating Hormone (MSH), oestrogen and progesterone are believed to be responsible for hyperpigmentation. Progesterone appears to increase oestrogen to signal melanin output, which stimulates pigmentary changes in the skin. This type of pigmentation is seen more in those with darker skin and hair. Melasma is said to be caused by stagnation of Liver energy, which effects the movement of qi and blood throughout the body. Acupuncture around the area of pigmentation is thought to help improve the flow of energy and blood, so that melasma are less pronounced in colour and size.

Tips – Protect the skin from sun exposure with physical sunscreens, as these reflect the heat away from the skin, which is good for a pregnancy-flushed face. Use a natural SPF 30+, such as zinc oxide and titanium dioxide. For targeting localised brown spots, opt for Vitamin C. For safe exfoliation, use Lactic Acid or a gentle exfoliating enzyme mask to brighten the skin.

Avoid – Limit exposure to ultraviolet light. Topical formulations containing hydroquinone and tretinoin should be avoided in pregnancy, but may be added after pregnancy, or as advised by your doctor. 

Acne

Although some women experience improvements or no change in acne during pregnancy, a substantial number suffer acne flare ups during this time, which may also indicate a higher risk for similar flare ups during future pregnancies. A shift in hormones, specifically progesterone, estrogen and androgens, during pregnancy can stimulate the sebaceous and sweat glands, resulting in more perspiration and oilier skin triggering breakouts. Studies show hormone levels spike during the earliest stages of pregnancy and often again in the third trimester, which may explain the initial onset of hormonal breakouts and then another surge of acne toward the end of pregnancy and up until birth. Acupuncture and Traditional Chinese Medicine, when combined with dietary and lifestyle modifications, may help to positively impact any skin changes, improve digestive function, reduce inflammation and redness, swelling and painful pimples, and bring your body into harmony.

Tips – Opt for oil regulating products such as niacinamide (B3) and bentonite clay spot treatment. Reduce acne triggering bacteria with zinc, topical probiotic/ferments, and antioxidants such as resveratrol and green tea.

Avoid – Concentrated salicylic acid formulations should not be used, as well as prescription and oral retinoids, and high strength topical retinoids. Always check the ingredients of your skin care for potential toxins.

Eczema

Atopic dermatitis, otherwise known as eczema, is another commonly seen skin condition that may be worsened through pregnancy. The reason for this is not well understood, but may be due to the effects of oestrogen on cellular responses in the immune system. Specifically, this involves a shift from cell-mediated immunity toward humoral immunity. Additionally, the high estrogen state of pregnancy stimulates mast cell activation and allergic responses. The relationships between skin, brain, and gut health and between eczema and the nervous system suggest an important role for acupuncture due to its known impact on calming nervous system hyperreactivity. 

Tips – Fish oils deliver anti-inflammatory omega 3s, which is great for skin inflammation and dryness of the skin. Probiotics containing lactobacillus rhamnosus are safe to use through pregnancy and helpful in atopic conditions. Mild gel/cream cleansers and products should be used, containing calming and soothing ingredients like Panthenol, chamomile and Licorice root. Barrier-building ingredients such as oats (Avena Sativa), sunflower seed extract and borage seed oil reduce irritation. 

Avoid – No hot showers or abrasive scrubs, as these will irritate the skin. Stay away from artificial fragrances and direct application of essential oils.

Acupuncture & Chinese Medicine

Because acupuncture sessions to improve skin conditions are focused on moving qi and blood, treatment will depend on your current health and stage of pregnancy. Sessions with me will mostly involve a combination of facial gua sha and sliding cupping to move lymph, increase blood circulation to the area, and encourage any skin changes to move towards skin healing, alongside constitutional and pregnancy support acupuncture, nutrition and lifestyle counselling.

Written by Holly Peyton-Smith

Holly Peyton-Smith is an Acupuncturist and Chinese Medicine Medicine Practitioner at Fertile Ground Health Group.

If you’re suffering with a skin condition and seeking treatment, please feel welcome to make a booking with Holly.

References

https://medcraveonline.com/OGIJ/a-review-of-the-clinical-and-immunologic-effects-of-estrogen-on-atopic-dermatitis.html

www.ncbi.nlm.nih.gov/pmc/articles/PMC3114665/

https://pubmed.ncbi.nlm.nih.gov/26957383/

www.ncbi.nlm.nih.gov/pmc/articles/PMC4311336/

https://www.hindawi.com/journals/ecam/2019/1907578/

What does your period tell you about your endometrial lining?

your period
The Chinese medicine take on the quality of your menstrual flow

As a woman, if you’ve ever had a Chinese medicine consultation, it is quite likely you’ve been questioned about the health of your endometrial lining and your period in some detail, even if you are not trying to conceive. We ask a lot of questions because every woman’s period gives us valuable insight into her overall health and these details inform our diagnosis and treatment. Your period reflects what has been happening in the previous weeks, months and years.  As we commence treatment, you may often notice positive changes in your menstrual flow, which give us valuable feedback that we are on the right track with your acupuncture and/or herbal treatment. Having a healthy period is always very important and is especially so if you are trying to conceive. 

Many of my clients are not used to observing their menstrual flow in such detail and may not know how to answer some of my questions. When I was a teenager, all I learned about my period was that it happened. The subject was taboo, only the essentials were discussed, and further information just wasn’t available. If you are the same, then it may take some months of observation to notice things you haven’t before. It is not uncommon that women return and tell me that their period is quite different to what they thought.

So, what do we want to know about your period?

Examples of some of the questions we may ask are:

  • How often do you change your pad or tampon (or menstrual cup or period undies)? 
  • How many days do you bleed for?
  • What colour is the blood? (Red, maroon, purple, black, brown, pink)
  • Is the viscosity like normal blood or is it thick and sticky or watery?
  • Are there any clots? If so, how big (specks, coin sizes, as big as your wrist)
  • Is there any pain? When does it start and finish? How strong? Where is it felt?
  • Does it stop and start?
  • Is there an odour?

What we are looking for are deviations from a healthy menstruation. It should flow easily, be pain free, be a fresh red colour and not contain clots, dark strands or mucous. There needs to be enough blood to reflect a lining of adequate thickness, but it must be healthy too. It should arrive without a lot of fuss, finish up neatly and not outstay it’s welcome. 

Prepare the garden bed

You may have heard the analogy of the garden bed. A strong healthy plant needs a quality nutritious soil that is free of weeds, rocks and clay. If we prepare the soil before we plant the seed, we have a greater chance of it taking root and growing big and strong. 

As a Doctor of Chinese medicine, my main therapeutic tools are herbs and acupuncture. Our herbs are prescribed as formulas containing multiple herbs chosen to suit your particular diagnosis. I mostly use soluble granulated herbs, although pills, tinctures and teas are not uncommon. All herbs are free from endangered species or unethically sourced products and are of the highest quality grade. Specific dietary guidance aimed at improving menstrual health may also be given. 

A Chinese medicine gynaecology or fertility consultation includes enquiring about your menstrual history and the details of your entire menstrual cycle, not just the period. We discuss your diet, digestion, lifestyle, work, stress and anxiety levels and any other health concerns or test results you may have. We use all this information alongside our traditional diagnostic techniques to inform our diagnosis and design your treatment plan. 

If you have been concerned about the health of your period, suffering every month with pain or heavy bleeding or have been having difficulty conceiving and are unsure what to do, then I would love to see you in clinic to discuss your concerns and possible treatment options. 

Written by Kim Riley

Kim Riley is available for one on one in person acupuncture and Traditional Chinese Medicine consultations. You’re welcome to book in with Kim.