New study shows acupuncture helps female infertility

Good news for women who want to get pregnant but are having difficulty conceiving - a recent study published in the journal "Complementary Therapies in Medicine" reports that Chinese medicine can increase the chances of getting pregnant. The authors state:

"Our review suggests that management of female infertility with Chinese Herbal Medicine can improve pregnancy rates 2-fold within a 4 month period compared with Western Medical fertility drug therapy or IVF [in vitro fertilization]. Assessment of the quality of the menstrual cycle, integral to TCM diagnosis, appears to be fundamental to successful treatment of female infertility."

For more details, you can read the abstract of this Chinese medicine fertility study. As the authors conclude, it is important to get a detailed history of the menstrual cycle in order to effectively treat female infertility. Your practitioner will ask you questions about your period (cycle length, duration of the period, associated symptoms and PMS, and so on), and will consider this along with other health history information, and examination of your pulse and tongue. All of this information allows your practitioner to make a diagnosis, and choose acupuncture points and herbs that are specific to you and your body.

Chinese medicine has a lot to offer women who are having trouble getting pregnant. If you are struggling with infertility, acupuncture and herbs can help you!

A short video about a resolution you can actually keep!

Happy New Year!

Like many people, I find myself thinking about areas of my life that I would like to change or improve. While it may seem arbitrary to make resolutions just because it's January 1st, I think it's always helpful to reflect on things in our lives that are working well, and to consider making changes where necessary. I try to do this every few months -- it helps to put things in perspective and make minor changes on a regular basis.

Some resolutions are smaller, day-to-day goals, like remembering to make the bed every morning or to take vitamins; other resolutions are larger or more long-term, such as the decision to quit smoking or to make a career change.

I recently watched a video called "23 and 1/2 hours", which answers the question, "What is the single best thing we can do for our health?" It's a really engaging presentation by a doctor / professor about the benefits of exercise. Some of the information he shares will be new, and other parts will definitely be familiar to you, but his way of sharing data is fun to watch. He suggests that we can all commit to doing some form of exercise for at least 30 minutes per day -- or, put another way, to limit sitting and sleeping to just 23-and-a-half hours per day. When put this way, the goal of exercising to improve health feels very manageable!

This is a great example of a resolution that is both big (improve my overall health) and small (exercise a little bit every day). If you are working on some health goals of your own, no matter what the size, acupuncture may help you achieve your intentions. I invite you to contact me to discuss how acupuncture can help you improve your health and your quality of life.

I wish you all the best in 2012!!!

Acupuncture and Pregnancy

You're pregnant! This is often a very exciting time for women, as they think about, and prepare for, the tiny life growing inside them. Ideally, you'll feel just as good during your pregnancy as you did before (and some women feel even better!). But just in case you are having any problems during your pregnancy, it's reassuring to know that acupuncturists are able to help you.

Women frequently come to my office while pregnant. The first question they often ask? "Is it safe to have acupuncture while I'm pregnant?" The answer is YES! There are a handful of points that a trained acupuncturist will avoid using on a pregnant woman, but, as I always tell my patients, we have hundreds of points to choose from, so we'll find something safe and effective. (It's worth mentioning here that this is a perfect example of the importance of seeing an acupuncturist who is licensed and has received adequate training in safety issues.)

What pregnancy problems can be helped with acupuncture? Here are some of the things I commonly treat, for which acupuncture is quite effective:

• Nausea / vomiting - Acupuncture is so effective for pregnancy related nausea that insurance companies will often cover it! Here is a research study abstract on the effects of acupuncture in pregnancy related nausea and vomiting. This is another abstract about acupuncture and nausea in general. Your acupuncturist can help you find diet and lifestyle modifications which may significantly decrease the nausea and vomiting you experience while pregnant. Reflux and heartburn can also be alleviated with acupuncture.
  
• Fatigue / exhaustion - This is a very common symptom during pregnancy, and acupuncture can help keep your energy level more stable.
• Aches and pains - The fact is, your body changes constantly when you're pregnant. These physical changes can put pressure on your joints, causing anything from mild to severe discomfort. Acupuncture helps relieve this discomfort so you can go about your day, and then get a good night's sleep! Here is a study looking at the effect of acupuncture and stabilizing exercises in the treatment of pelvic girdle pain during pregnancy. This is an abstract about acupuncture for back pain during pregnancy. Acupuncture can be really helpful here since many women want to avoid taking pain medication while pregnant.
• Changes in mood - Some women don't want to take medications for mood or anxiety while pregnant, or their doctors may be advise them to stop certain medications. This study about acupuncture treatment for depression during pregnancy suggests that acupuncture can be very helpful.
  
• Threat of miscarriage - Certain women may be at a higher risk for having a miscarriage. Your OBGYN can advise you on steps you can take to decrease your chances of miscarrying. Acupuncture can also help decrease this risk. Herbs may be recommended as well - just be sure the person who gives you the herbs is board-certified and aware of safety issues associated with herbs and pregnancy! Not every herb is safe to take while pregnant, but there are many herbal formulas designed specifically to support your pregnancy, and a trained practitioner can find one that is appropriate for you.

These are just a few examples of how acupuncture can help pregnant women. If you are wondering if acupuncture can help you with another symptom of your pregnancy, feel free to contact me.

Pregnancy should be a time of health and well-being for you and your baby. Let acupuncture help you feel your best during this time!

Acupuncture and IVF Part 2 - During IVF Procedures

In my last blog post, I talked about the uses of Chinese medicine while preparing for IVF. This post is about how acupuncture can help you and your partner once IVF procedures are already underway. Doctors and fertility clinics have a set of procedures that they usually follow, and acupuncture may be appropriate at each of these stages to enhance fertility and optimize the chances of a successful IVF cycle. As I mentioned in my last post, several of the large IVF clinics in NYC recommend acupuncture during the IVF cycle to increase the likelihood of pregnancy.

• Regulating the cycle: Often, about a month before IVF is going to start, the doctors will start you on hormones to regulate your cycle. This allows them to know exactly when they will need to retrieve mature eggs. During this time, acupuncture can be used to regulate qi (energy) throughout the body, improve blood circulation, and calm the whole nervous system. In other words, your acupuncturist will try to nourish and replenish your body during this time, so that you are as healthy as possible going into the next stage of the IVF cycle.

• Stimulation of the ovaries: Most patients are asked to return to the doctor's office on Day 2 of their cycle (the second day of your menstrual period). Assuming that the doctor thinks it's appropriate to go ahead with the IVF cycle that month, he or she will start you on hormone treatments to stimulate the ovaries so that you will make more follicles. Acupuncture can be very helpful at this stage as well - it can assist in producing more follicles, and can also be very helpful in thickening the lining of the uterus. This is important because it allows the transferred embryos to attach more easily to your uterus. Many women struggle with side effects of the hormones and drugs they take during this stage, so acupuncture can help with things like cramping, constipation, soreness, breast tenderness, mood swings, fatigue, and headaches that may arise.

• Retrieval of eggs: Now it is time to retrieve the mature eggs. Your doctor will remove mature eggs from their follicles, and combine those that are viable with the most promising sperm. Retrieval is a surgical procedure which sometimes causes discomfort for women. Acupuncture can be useful at this stage to calm uterine cramping, reduce irritation or inflammation from the surgery, and again to address side effects from the hormones and medication.

• Transfer of embryos: The eggs and sperm are combined in a lab and watched carefully while they (hopefully) meet and fertilize. Those eggs that fertilize will be allowed to continue developing for either 3 or 5 days, and then when the doctor feels they are viable and stable, one or more will be transferred back to the uterus. This day, the "transfer day", is one where acupuncture is often recommended by fertility clinics and doctors, as there is quite a bit of research indicating that acupuncture improves the chances of a successful transfer and pregnancy. On the transfer day, your acupuncturist will meet with you two times - immediately before and immediately after the transfer happens at your doctor's office. (This German study on acupuncture and IVF is quite interesting and compelling. Also see my previous blog post for links to research articles about acupuncture during IVF transfer.) In my practice, the acupuncture / transfer schedule looks something like this:

* The patient is told that transfer will happen on (for example) Monday at 12:00 noon;
* The acupuncturist meets the patient at 10:30, about 90 minutes before transfer is scheduled to occur;

* Acupuncture points are inserted according to successful research protocols (possibly with additional points specific to the patient, if needed). This is the "pre-transfer" treatment, and the patient rests for about 30 minutes with needles inserted;
* Needles are removed, and the patient makes her way (in a casual and relaxed fashion, with plenty of time to spare) to the doctor's office, where fertilized embryos are transferred to her uterus;
* After being cleared to leave, the patient calls the acupuncturist to say that she's on her way back to the acupuncturist's office for the "post-transfer" treatment;
* The needles for the "post-transfer" treatment are inserted, and the patient is left to relax for about 30 minutes;
* The patient goes home to rest!

What are these "pre-transfer" and "post-transfer" treatments for? The pre-transfer treatment uses points that help dilate the cervix, which makes it easier for the embryos to be inserted into the uterus. Some points help improve circulation of blood to the uterus, thus creating a thicker uterine lining. There are also points to calm the patient's whole nervous system, which in turn calms the uterus. This relaxing of the uterus is important because it decreases cramping and uterine contractions - the more relaxed the uterus is, the more likely it is to allow for successful implantation.

The post-transfer treatment continues these ideas - it circulates blood to the uterus and nourishes the newly implanted embryo so that it can grow, and helps to prevent contractions of the uterus.

And now... we wait. Your doctor will tell you when to return to the office for a pregnancy test. In my next post, I will discuss some of the ways that acupuncture can help you during your pregnancy. More soon...

Acupuncture and IVF Part 1 - Preparing for IVF

IVF stands for in vitro fertilization, meaning that the egg is fertilized by the sperm outside of the womb. ("Vitro" means glass, referring to the lab equipment where the fertilization takes place.) Typically, IVF is done in situations where a woman is unable to get pregnant through intercourse alone. This may be due to her age, previous health issues that have affected her fertility, or issues with a male partner's sperm. IVF may also be used in cases where the woman wants a child but does not have a male partner.

No matter what the situation, it may be appropriate to consider acupuncture as an adjunctive therapy when starting IVF; in fact, many of the large fertility clinics in NYC recommend acupuncture throughout the IVF process!

A lot has been written about acupuncture and IVF. There have been many research studies that show that acupuncture can greatly increase the chances of IVF success, which is welcome news to anyone going through the process. For those interested in research about this topic, you may want to visit these links. (There are MANY studies - this is just a small sample!)

• A frequently cited study showing a pregnancy rate of 42.5% in those who had acupuncture with IVF (significantly more than in those who did not use acupuncture during IVF)
• A study about acupuncture done on the day of transfer or 2 days after transfer versus no acupuncture at all, showing that the acupuncture groups had higher rates of pregnancy
• A study indicating that acupuncture treatments designed to promote fertility resulted in more pregnancies than treatments not aimed an increasing fertility

There are several stages to the IVF process, and acupuncture helps in different ways during these stages. Today's post is about the first part of IVF, and the use of acupuncture to prepare your body before IVF procedures begin.

To help you prepare for IVF, acupuncturists have several goals:

• Improving ovarian function: Part of the IVF process involves stimulating the ovaries to produce more follicles and higher quality eggs. Often, it is impossible for a woman to get pregnant because of poor egg quality resulting from age or illness (or for other reasons that may be unidentified). Obviously, healthy eggs are the basis for a successful pregnancy! Acupuncture can help increase the number of eggs and the quality of those eggs in the month(s) leading up to the IVF procedures.
• Lowering FSH levels: A high FSH (follicular stimulating hormone) level suggests that the ovaries are not functioning as well as they should be. Acupuncture helps to regulate hormone levels and improve ovarian function, which in turn lowers FSH levels. This is important because many IVF clinics will use the FSH level to help decide whether or not it is appropriate to go ahead with IVF procedures that month.
• Improving immune system functioning, reduce side effects of IVF medications, and reduce stress: Some women (not all) experience side effects from the medications that are used to prepare their bodies for IVF. These side effects are varied, but commonly include things like abdominal bloating, abdominal or uterine cramping, mood swings, or mild depression. Some people (both men and women) find the experience of trying to get pregnant or of going through IVF stressful, and reducing that stress can help the whole process along. Acupuncture is a good way to calm the body, reduce discomfort, and alleviate stress while preparing for IVF.
• Improving the quantity and quality of semen: While much of the IVF literature focuses on the woman, it should be noted that acupuncture can be very helpful to men as well, especially in cases where part of the of difficulty in getting pregnant lies in poor sperm count, low motility (movement) of sperm, or sperm that are not formed correctly (poor morphology). You need healthy sperm to have a good chance at a successful IVF, and a couple of months of acupuncture can help create better sperm before IVF even starts.
• Dietary recommendations: In Chinese medicine, diet is always an important consideration for achieving optimal health. As someone prepares for IVF, an acupuncturist may suggest that they reduce the amount of cold, raw food that they eat or drink. It may also be helpful to decrease the amount of caffeine. Nourishing, warm, cooked foods are wonderful for promoting fertility and increasing the chance of success with IVF. Think about soups, stews, beans, lentils, chicken, eggs, cooked vegetables, and perhaps some red meat both before and during the IVF process.

I am frequently asked if it is "too late" to start acupuncture for IVF by women at various stages of the process. My general answer is that it's never too late -- the effects of acupuncture can be both immediate and long-term. Ideally, I love to see people start acupuncture a couple of months before starting IVF so that the body is in its optimal condition going into the process. However, for some people this is not an option, in which case I always feel that some acupuncture is better than no acupuncture while trying to get pregnant!

My next blog post will discuss how acupuncture can help you once the IVF procedures are already underway. Stay tuned...