Fertility statistics 2012-2013

2013 is not quite over yet – but here are the initial results from all women trying to conceive using acupuncture in the past 24 months. As well as acupuncture, patients were given advice on diet, lifestyle and over the counter herbal preparations. Please take notice of the inclusion criteria for each group. The most common reasons for women not being included in the statistics are;

i) Not having regular acupuncture sessions over 6 months (defined at the initial consultation as being between 2-3 sessions per month depending on the individual case).

ii) Not keeping in touch – so outcomes are currently unknown

GROUP 1 – Natural Fertility with Women aged 35 and under. Patients must not have used Clomid or undergone IVF with 3 months of commencing acupuncture. Women getting a positive pregnancy test during or within  6 weeks of their last appointment were included. All patients committed to regular sessions for at least 6 months. Several women have been included twice (due to initial miscarriage and then restarting acupuncture).

83% of women had a positive pregnancy test

Of these women 20% suffered early miscarriage before 12 weeks, (all women who experienced miscarriage recommenced acupuncture and are either currently in their 2nd or 3rd trimester OR are starting another 6 month course of acupuncture).

GROUP 2 – Natural Fertility with Women aged 36 and over. Patients must not have used Clomid or undergone IVF with 3 months of commencing acupuncture. Women getting a positive pregnancy test during or within  6 weeks of their last appointment were included. All patients committed to regular sessions for at least 6 months.

67% of women had a positive pregnancy test

Of these women 25% suffered early miscarriage before 12 weeks – all were over 44 years of age.

GROUP 3 – IVF Support for Women aged 35 and under. For patients having acupuncture for more than one round in this time frame  the most recent is included. A positive test is defined as one that is present at least 4 weeks after embryo transfer. To be included in the IVF category patients must have seen me as their primary complementary therapist.

80% got a positive pregnancy test

All women in this group started acupuncture at least 4 weeks before any IVF medication. There were no reported incident of miscarriage in this group.

20% did not get a positive pregnancy test

None of the women in this group started acupuncture before the IVF medication

Group 4 – IVF Support for Women aged 36 and over. For patients having acupuncture for more than one round in this time frame  the most recent is included. A positive test is defined as one that is present at least 4 weeks after embryo transfer. To be included in the IVF category patients must have seen me as their primary complementary therapist.

89% of women got a positive pregnancy test

All of these women had started acupuncture at least 4 weeks before the IVF medication. The miscarriage rate in this group was 13% (all before 12 weeks).

11% of women did not have a positive pregnancy test after 4 weeks.

All of these women also had started acupuncture at least 4 weeks before the IVF medication.

Group 5 – Pregnancy rates within The Norwich Natural Fertility Partnership. To be included in these statistics couples must commit to 12 months of regular appointments. Couples not included in these statistics are those that failed to keep to their given schedule and did not continue past the first block.

Couples whereby the woman is 35 and under – 100% pregnancy rate with no reported miscarriages (includes cases with both male and female fertility issues).

Couples whereby the woman is 36 and over – 100% pregnancy rate with no reported miscarriages (includes cases with both male and female fertility issues).

Currently the longest time it has taken for a couple to achieve pregnancy from the initial start date is 10 months.

 

 

Relieving pre-menstrual syndrome

Premenstrual syndrome (PMS) is a set of unwanted physical, emotional and mental symptoms that occur after ovulation and are relieved as the period gets started. Most women (and their partners) are well aware of the changes in mood alongside minor physical complaints such as bloating just before the period, and there is nothing ‘wrong’ or unhealthy about this. However when the symptoms go on for up to 2 weeks and cause severe mental and emotional disturbance this can have a very real effect on a woman’s life – her work, her relationship and her self esteem. Women with severe PMS can feel like 2 completely different characters – and to some extent they are!

Below are some of the most common unwanted symptoms of PMS:                                                Mood swings, Irritability, Anxiety and tension, Bloating,                                                                Breast tenderness and swelling, Water retention                                                                 Acne, Tiredness, Weight gain,  Headaches/migraines,                                                            Crying Spells, Depression, Sugar and food cravings,                                                                       Constipation, Dizziness and Night sweats.

So whats going on in our bodies to cause all this? Typically, as with so many problems in women’s health, there is no single causative factor, but a combination of several smaller imbalances that all trigger each other off.

Firstly, just looking at our hormones – oestrogen levels are declining and progesterone is on the up. This shift can affect some women very strongly. A popular theory is that at a time when progesterone should be high, in women with PMS, their oestrogen is actually still too high in relation to progesterone. Many of the physical symptoms such as water retention, breast tenderness and bloating can be attributed to oestrogen.

Secondly, as well as regulating the menstrual cycle, oestrogen and progesterone influence neurotransmitters such as serotonin which will then fluctuate throughout the menstrual cycle. Serotonin is just one of the several mood affecting neurotransmitters likely to be involved and can explain the panic attacks and severe depression and anger that some women experience.

Thirdly, stress is nearly always involved in some way. Although it is unlikely to cause it, it will undoubtedly worsen PMS symptoms. Overworking, not enough sleep or over worrying will all cause stress to pile up. One of the stress hormones, cortisol is thought to block progesterone receptor sites, thereby aggravating the oestrogen / progesterone balance.

The Chinese medicine approach is to look at the whole menstrual cycle. What’s going on the rest of the time? – does the diet support the liver in breaking down oestrogen for elimination and is stress being managed before ovulation for example.                               In acupuncture the first half of the cycle is ‘Yin’ This is a time for nourishing the body and mind, eating and sleeping well. The second phase between ovulation and bleeding is ‘Yang’ which represents movement, warmth and energy. PMS in acupuncture is sometimes seen as too much Yang rushing around the body causing mental and emotional upset so the aim is to ground this energy, and to keep in circulating round the entire body in a more balanced way. We do this by building up the Yin in the first half of the cycle so it is strong and abundant – so strong that in anchors the Yang later on!                 In other cases there is not enough Yang – and so the Yin starts getting sticky, heavy, sluggish and obstructs the Yang from coursing through the body. This leads to stagnation such as constipation, bloating and so the aim is to get the Yang / energy of the body freed up so it can zip through the body, moving all the sludge on the way.

I work with women of all ages to help combat the PMS once and for all. We follow a plan of acupuncture twice a month in between ovulation and her period. This really focuses on getting her yang moving evenly throughout her body and head, and this is the time to keep things moving physically with yoga or swimming. We change her diet slightly to support her Yin in the first half of her cycle and ask her to spend some time slowing down just with herself. I also add in herbs alongside Andrew Chevallier to really support a healthy progesterone / oestrogen balance. After 3 menstrual cycles a substantial improvement is nearly always seen, with most women not needing to continue with the acupuncture.

 

Painful periods – Dysmennorhoea

Woman of all ages regularly come to see me at the acupuncture clinic for help with pain around menstruation. A small amount of cramping and aching is normal on the first day, but for many the pain is unbearable and disrupts everyday life. Painful periods with no serious underlying causes is known as ‘primary dysmennorhoea’ – there is no obvious medical reason why this happens. Pain that is related to conditions such as endometriosis and fibroids is called ‘secondary dysmennorhoea’. This too responds well, though these conditions deserve a separate article to themselves.

In Chinese medicine, pain is seen as ‘stagnation’, and usually with severe period pain we call it ‘blood stagnation’. The underlying cause of this stagnation can be a combination of many things and the job of your acupuncturist is to work out what these may be. Acupuncture visualizes everything in the body in constant motion, slowly and gently. The pain results when the blood and Qi of the pelvis can’t move in the direction it needs to, instead it sits and creates a blockage like a dam, and as the pressure builds up you feel more and more discomfort.

I really see very good results using acupuncture, diet and lifestyle changes. My top tips for managing primary dysmennorhea are the following;

1. Acupuncture regularly – in the second half of the cycle. I usually ask to see my clients twice before their expected period starts. I needle directly on the lower abdomen and the legs using lots of heat to relax the muscles. Sometimes we also work on the lower back and sacrum too. It really doesn’t hurt. The needles just sit under the skin and once in place, the body responds to them by releasing a whole load of various substances which will aid in general pelvic circulation. You can’t usually feel this happening ( some women will be aware of tingling and warmth or muscles relaxing), but it takes around 20-30 mins which is why you will just be lying there listening to music and daydreaming.

2. Discourage ‘bad prostaglandins’ by reducing all meat and dairy produce –  small amounts can be taken (they must be organic). Prostaglandins are present in all cells of the body and most have a beneficial effect. There are a few that are related to constriction and inflammation and too much of these types will cause an imbalance. Women suffering with severe dysmennorhea are found to have higher levels of two particular types of prostaglandins known as PGF2 and PGE2. The fuel the body needs to make these ‘negative prostaglandins comes from arachidonic acid which is abundant in meat and dairy. So cutting these out will make it harder for the body to produce PGE2.

3. Encourage ‘Good Prostaglandins’ – To tip everything in our favour we need to add certain things into our diet. Lots of the ‘good prostaglandins’ will help the uterus contract beautifully and with ease. Adding in lots of oily fish, nuts, seeds and leafy greens will do this. You also need to have adequate amounts of certain vitamins and minerals in your diet so that your body can create these good prostaglandins. Everything should be present in a varied healthy wholefood diet, but if your diet is compromised you may need to take these as supplements short term to boost your levels.

4.  Pelvic stretches – absolutely essential for getting good circulation going. I have a set of yoga stretches I show to each woman that really get deep into the groin. There are plenty of short videos on You Tube for inspiration too. You want to be doing 10-15 mins every 2 days initially. The 5 days before your period you must do every day. Everyone can find time to do 10 mins – once you are familiar with the stretches you can do them in front of the TV in the evenings. After a few months you will probably not need to do them so often as the overall circulation has improved. The one exercise to avoid if you suffer from painful periods is of course sit-ups.

As with many things in natural and complementary medicine – it is the combination of a few small changes here and there which give dramatic results. In acupuncture we don’t accept that severe pain at menstruation is ‘normal’ and something to be put up with. Working with your body requires time and patience and a genuine desire to get to know yourself. Using the 4 interventions above, I see huge reductions in the monthly pain within 6-10 weeks. If you or someone you know suffers with debilitating cramps – please get in touch with the clinic to see how we can help you.

 

Open Day – Fertility Acupuncture in Norwich

As part of The Norwich Natural Fertility Partnership open day, I will be available for free advice and chats at the clinic on Thursday 13th June. If you would like to know more about which complementary therapies are best suited to you and your partner, whether trying naturally or alongside IVF – this is an excellent opportunity to speak with us directly. You can drop in on the day, or if you would prefer not to be waiting you can pre-book a 15 min slot by ringing reception on 01603 665173.

We look forward to meeting you!

The NNFP team

Prepare for Childbirth

We see many women at various stages of pregnancy at our clinic – what is particularly rewarding is seeing women in the last few weeks as they prepare for the big day. Acupuncture is well known for it’s ‘labour inductions’ – but what does this actually involve?

Well for starters, it is a very gentle form of acupuncture as pregnancy often makes women more sensitive to stimulus. We make sure you are in a comfy position on the couch with your back raised and supported by blankets and cushions. The obvious points in an acupuncturists mind are Hegu and SanYinJiao. This combination of points is in fact forbidden throughout pregnancy because of the supposed strong action on the uterus. The only other time these might be used are straight after embryo transfer in IVF – before implantation. Hegu is on the fleshy mound between the thumb and index finger. SanYinJiao is just above the ankle of the inside of each leg.

Other points can be added in depending on the tongue and pulse diagnosis, and once they are all in it is just a case of lying there and relaxing! It can take between 1-3 acupuncture sessions to get things going – though I rarely need to do more than 2. Baby can suddenly get quite active during the session – though it usually settles down towards the final few minutes!

I often see first time mums who still have a low level anxiety about labour despite attending all the NCT classes and reading every book available on the subject – this is normal! For second time round mums it is often a case that they haven’t got time to prepare for labour – they are so busy looking after small people, and suddenly they find themselves at 39 weeks without realising! Acupuncture is great because it plugs you in fully to your parasympathetic nervous system – the part responsible for dilation and relaxing! Using your breath to connect with the parasympathetic is also excellent in the run up to labour. Set aside 10 minutes each day and take long deep full breathes somewhere peaceful or in nature. Common advice to women who are overdue is ‘walk walk walk and then walk some more’. In Chinese medicine we say the opposite. Fine have a little gentle stroll around BUT! – Conserve your energy, you’re going to need it! I see too many exhausted women who are walking miles each day to avoid a medical induction date.

For an acupuncture ‘induction’ you need to make sure baby’s head is down and that the placenta is not covering the cervix. You also need to have been cleared for a vaginal delivery by your midwife.

At The Complementary Health Care Clinic we have a gift vouchers available which combine reflexology, craniosacral therapy and acupuncture together. They are the perfect gift for a mum-to-be! Three hours of relaxing complementary therapy from experienced practitioners especially good from week 36 onwards.

 

What can you do to boost your fertility naturally?

Searching for the best foods to help you get pregnant can be incredibly confusing! Just a few minutes spent online and you will find a huge variety of do’s and don’ts, some of which contradict each other – and others which involve strange new super-foods and supplements!

At The Norwich Natural Fertility Partnership we do not believe in a one-size fits-all-diet. Since most of us eat at least three times every day – food really is a major influence in how our bodies grow and function each month. Every time you eat you are giving your body the raw materials with which to fuel development and function in each and every part of the body, be it the iron of hemoglobin in a red blood cell or vitamin E boosting production of immune B-cells.

The food we eat can also hinder normal functioning of the body. A good example of this is the liver, the amazing organ that allows us to get rid of unnecessary cells –  be it toxic substances or excessive levels of hormones. If our liver is working overtime due to poor diet and drinking habits it can struggle to carry on with all its day to day chores of general waste removal that any body will generate.

Keeping the blood sugar levels is essential for women trying to conceive. The pancreas like the ovaries is a gland, and insulin just like oestrogen and progesterone is a hormone. Hormones and glands act as ‘messengers’ within the body, giving instruction to cells to behave in a certain way. Functioning together as the endocrine system, a change within one gland can affect a seemingly unconnected gland. The ovaries, thyroid, pancreas and adrenals work in harmony together – so keeping your blood sugar and insulin levels happy sends a positive message to the rest of the system including your ovaries!

The adrenals are well known for the part they play in the fight or flight response – the hormones adrenaline, noradrenaline and cortisol all are produced here. However they also play a part in reproductive physiology producing androgens and oestrogen. Many of these hormones share the same precursor cells – so they can develop in one of several ways. By making sure your adrenals are not constantly under stress,  these precursor cells can then be directed towards maintaining a hormonal balance and support what is happening with the ovarian hormones.

Interestingly within Chinese medicine the three major organ systems of female reproduction are the Kidneys, Liver and Spleen/pancreas –  it is similar to conventional medicine in that harmony between all systems is paramount when trying to conceive. These three meridians run up the inside of the legs before diving deep into the pelvis which is why you often have needles in the ankles or knees with fertility acupuncture.

At the Norwich Natural Fertility Partnership here in Norwich we have 5 Golden Fertility Rules!

1. GO ORGANIC – essential for animal produce, meat and dairy.

2. DRINK 1.5 LITRES GOOD QUALITY WATER DAILY – invest in a good quality water filter or buy spring water.

3. EAT REGULARLY AND INCLUDE PROTEIN AT EACH MEAL – this is the one rule that catches many of my clients out!

4. INCLUDE 7-10 PORTIONS OF FRESH FRUIT AND VEG EVERY DAY – again this is harder than it first appears!

5. MAINTAIN A HEALTHY BMI – I see an equal number of women who are slightly underweight compared to women slightly overweight. You should make sure you are firmly between 19 – 24.9, the research overwhelming supports this as indicator of fertility.

One of the best studies done on diet and female fertility was done by The Harvard Medical school over 8 years and looking at over 17,000 women. Interestingly it found that women who gained more iron from vegetarian sources (without actually being vegetarian) were more likely to have healthy ovulation. At The Norwich Natural Fertility Partnership we work on a diet suited to you, your lifestyle and underlying health conditions.

A typical fertility session with acupuncture

 

Prior to booking an initial consultation for fertility, many women ring in first just to find out a little bit more about how I work.

Usually I will have agreed with my client beforehand to book her appointment at key points in her cycle – around day 7, 14 and 21, though this can vary hugely depending on the length of each woman’s cycle. We start off with a general chat about how she felt after the last acupuncture session and how her week has been mentally, emotionally and physically. If she has been charting (checking her daily temperatures), keeping a food diary or has brought in a recent set of blood results she hands over everything to me. Depending on what arises in our conversation combined with her Chinese tongue and pulse diagnosis I decide whether to start needling on her back or front. It can be a very different experience lying face up or down – and some women have a clear preference about which makes them feel better afterwards! I tap all the needles in very gently at first, then revisit each needle and work with my client to achieve the ‘De-Qi’ sensation on as many points as possible rechecking the pulses as I go. Heat lamps and electro-acupuncture are added now if needed.  Once I am satisfied that my client is comfortable and warm, I turn the lights down, gather up her notes and leave the room.

While she is relaxing I sit in a  nearby room, writing up her notes and examining any new information she may have brought in. This is the time when I review her progress and make a decision about what I will ask her to do out of the clinic until her next appointment. The acupuncture needles stay in for 25-35 mins and occasionally longer if needed. When I return, I check the pulses again before removing the needles, leaving the room while my client dresses. We then have several minutes at the end of each session to discuss lifestyle or dietary changes for that week and make a ‘contract’ about what realistically can implement.

With each woman we quite early on decide on a key marker (or several markers), that would indicate to both of us that progress is being made. An example could be a change in the menstrual flow – in Chinese medicine we aim for a period that starts with bright fresh looking blood with minimal clotting that is at it’s heaviest in the first two days before tailing off to a scanty bleed for the rest of the period. So if one of my clients has an extremely scanty and brownish coloured menstrual bleed throughout, a key marker would be a increase in flow and redness of her bleed. In Chinese medicine this is equated to improved Yin and Qi in the pelvic region, but you could also relate it to a thicker endometrial lining from a conventional perspective.

I constantly refer back to these key markers in each case – sometimes acupuncture alone is not strong or quick enough to change the environment in a woman’s body and that’s when I will ask her to implement a change in her life that week. Very often I ask my clients to commit to one yoga and meditation class per week. In my opinion it is one of the most effective ways of managing stress, improving circulation to the pelvic region – undoing the effects of sedentary desk jobs and heavy workloads. And it’s a fraction of the price of acupuncture! It is simply my ‘wonder tool’ for bringing anyone back into balance physically and mentally and most importantly the only thing my clients have told me that has stopped the internal stress caused by not getting pregnant! There are many fantastic yoga teachers in Norwich, I recommend Louise Kitchener and Michelle Busuttil for yoga that truly transforms you from inside out!

Often I will ask my clients to alter their diets. I may be encouraging them to gain or lose weight and most often making sure they eat warm well cooked meals. Yes strange as it may seem cold salads and refrigerated sandwiches are not on the menu with fertility acupuncture! All meals should be warm and easy to digest – so cinnamon porridge instead of cornflakes for breakfast and soups instead of sandwiches at lunch.

The combined effects of acupuncture and lifestyle changes should yield noticeable results within 2-3 menstrual cycles. The initial focus is on these key markers – welcoming each new improved menstruation as a sign the body is becoming more fertile rather than the common pattern of sadness and frustration if the period arrives. It is difficult to shift the attention away from a positive pregnancy test – but that is often the key with fertility acupuncture – enjoying the journey, observing the changes in oneself and knowing everything is happening just as it should.