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.

 

 

Creating A Calm and Supportive IVF Embryo Transfer Day

By Amy O’Brien, FGHG Acupuncturist and Chinese Herbal Medicine practitioner

Working at Fertile Ground as an Acupuncturist there is a lot of opportunity to understand how women are feeling on the day of their embryo transfer. We treat with acupuncture once or twice on the day of transfer, and there is a real wisdom in the instant feedback of what women share about their experience of this day.

The things they are glad that they put in place, and the things they wish they had done differently. The emotions and physical terrain they’re navigating, and what’s helping their head, their heart and their body. The ways they feel isolated, or vulnerable or scared or hopeful. Things they might believe are true only for them, but which largely apply to majority of women in a similar circumstance.

IVF is such a big process. Often overwhelming, and often a case of taking things one day at a time. And yet, when it comes to embryo transfer, it can be really quite useful to plan ahead a little too.

For example, almost every woman who tries to work on the day of their embryo transfer, and around their acupuncture appointments, inevitably says ‘Gosh, I really should have just taken the day off. It would have made things easier.’ So for a woman approaching her first transfer, this is really useful to know!

And for women who have experienced an embryo transfer before, and is preparing for another, this can be a great opportunity to up level self care and self compassion on this day.

We don’t know what we don’t know, so let me offer up some insight from the collective experience of embryo transfer day.

Here’s a list of things that you might just find useful to implement on the day of your embryo transfer. It’s packed with insight I have gained since the day I first offered Acupuncture on the day of transfer at Fertile Ground, eleven years ago.

These are all relatively easy to implement. Relevant for all kinds of cycles. And focus on navigating a day that is not only stacked to improve outcomes, but to care for the beautiful human you are, too.

All the best for your cycle, and we look forward to supporting you along the way.

LINK:

https://www.thewrittenelixir.com/post/embryo-transfer-day

 

Amy O’Brien, FGHG Acupuncturist and Chinese Herbal Medicine practitioner, and creator of The Written Elixir

Amy facilitates a space where people feel confident to explore their health challenges. She recognises how anxiety, insomnia, digestive and sleep disorders can hop along for the ride when lovely women are grappling with issues surrounding their cycles, fertility and pregnancy. Amy is comfortable treating all aspects of women’s health including period problems, cycle irregularities, preconception, fertility and pregnancy care.

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