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.

 

 

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.

 

What to eat according to Traditional Chinese Medicine

In Chinese medicine we believe how you eat and live has a direct effect on your overall well being and stamina. We also think there is no one super diet that suits all people – by looking at your symptoms, body type and lifestyle we will suggest which of the Chinese patterns fits your constitution and encourage you to eat appropriately. For us foods are not ‘good’ or ‘bad’, but they all have a specific effect on the body. Knowing what foods help or hinder your conditions are key to long term prevention and management of your health.

Starting with ‘Heat’ – heat often shows up as a fast pulse, short temper, headaches, red eyes, high stress levels, dark urine, inflammatory conditions, redness in the skin – especially the face, heartburn, yellow coating on the tongue, dry mouth, thirst and hunger, bleeding gums and short menstrual cycles. Heat moves things along – sometimes to quickly and diet is used to cool and slow down its effects.

Avoid: Coffee, alcohol in general especially wines and whiskies, chilli, beef and lamb.

Include plenty of the following: (generally fresh fruit and plenty of drinking water is good). Avocado, green leafy veg, salad veg, cucumber, green mung beans, rice, oats, bamboo shoot, banana, bitter gourd, clam, crab, grapefruit, persimmon, salt, seaweed, star fruit, sugar cane, water chestnut, watermelon, lotus root, cucumber, barley, bean curd, chicken, egg white, oyster, pear, peppermint, radish, strawberry, tangerine, and yoghurt, broccoli, cauliflower, courgette, corn, tomatoes, pineapple, turmeric, soya.

Herbal teas – nettle, camomile, peppermint, black tea

Food preparation: Steamed, boiled, raw

Exercise: Gentle tonifying like yoga, swimming, walking and cycling. Avoid over exercising.

Some ‘Heat’ conditions have an underlying deficiency of ‘Yin’ – or the natural cooling properties of the body. In these cases we look to add foods that build this coolness up rather than let off steam. A lack of Yin or moisture in the body might display a mixture of the above heat signs and the following; a thin narrow pulse, pale or cracked tongue, dry skin and hair, scanty periods, fatigue, dizziness, poor vision, night sweats, hot flushes, insomnia and a dry cough.

Include plenty of the following; Avocado, green leafy veg, salad veg, cucumber, green mung beans, rice, oats, barley, millet, fish, chicken, spirolina, chlorella, seaweeds, coconut, honey, royal jelly, black beans, kidney beans, sweet potato, root veg, blueberries, blackberries, mulberry, flax, pumpkins, sunflower, black sesame, pork, duck, lamb, eggs, oyster, fresh figs and dates, maca, banana

Food preparation: Keep foods well cooked and easy to digest. Minimise raw food preparation.

Exercising: Gentle restorative like yoga, walking and pilates. Avoid cardio exercise or that which makes you sweat. Make sure you get 8 hours min sleep / night or allow yourself an afternoon nap.

Yin Breakfast:

  1. Mash together – 1 ripe avocado, 1 teaspoon spirolina, 1 tablespoon flax oil, salt and pepper to taste and have on toasted rye bread.
  2. Poached eggs on rye toast with rocket and omega oils.
  3. Oat porridge with chopped pears, figs, dates, maca powder and cinnamon – use rice / nut milk.
  4. Yin smoothie:1 ripe pear, 1 ripe avocado, 1 teaspoon spirolina, 1 tablespoon protein powder and almond milk to taste.
Damp‘ conditions are sticky, heavy and sluggish. Modern food choices contribute to damp accumulation and combined with living in a damp northern hemisphere country, these conditions are the most common and yet often hardest to change since they involve the most abstinence!
Damp can be hot or cold, but it tends to show up in the body in the form of mucus. This might be in the respiratory system, the sinuses, the bowels or the reproductive system. It’s cloying and heavy nature creates muzziness in the head and limbs. In the acupuncture clinic we would look for water retention, bowel problems, weight gain, general fatigue, thick coating on the tongue, and sluggish metabolism.

What to avoid is more important with Damp providing the rest of the diet is balanced and healthy.

Avoid: Dairy, sugar, refrigerated foods, raw uncooked foods, bananas, peanuts, fried foods, beer, mushrooms,  vinegar, refined wheat products, iced water, chocolate.

The following are particularly helpful in supporting damp conditions:  rice, toasted oats, sourdough breads, buckwheat, millet, rye, root veg, pearl barley, aduki beans, alfafa, miso, garlic, onion, cinnamon, ginger, scallion, basil, rosemary, dill, oregano, sage, parsley, cardamom, nutmeg, fennel, anise, clove, coriander, leek, chives, turmeric, asparagus, leeks, stewed fruit- esp. pears,

Herbal teas : dandelion, fennel, ginger and lemon, licorice, nettle.

Food preparation:  Baked and grilled are ideal. Keep all foods well-cooked and chew food thoroughly. Use max 1 tablespoon oil if frying onions for stews. Do not drink water alongside meals – drink plenty before and after. Eat at regular time and never skip breakfast. Start the day with warm water and lemon.

Exercise: All types good for the damp condition though not excessive swimming. Avoid swimming if menstruating.

Lifestyle: Keep long hair dry outside, clothing completely dry, homes dry and well ventilated. Keep moving throughout the day – if doing sedentary work take full advantage of lunch break to walk around town.

Heat-Damp accumulation: Similar to cold-damp what you cut out usually provides the greatest benefit. Additionally avoid alcohol and excessive chilli. Include plenty of bitter and sour flavours.

Keep foods easy to digest, boiled, steamed, baked and grilled. Make sure salads if taken are at least room temp.

 

Examples of cooking for damp conditions:

Porridge made with water, cinnamon, ginger, almonds and chopped figs

Beans on toasted rye bread

Root vegetable stew with 1 tablespoon miso stirred in just at the end

Baked sweet potato with tomato and aduki bean stew

Tahini sauce – tahini mixed with lemon juice, salt and fresh garlic with oat cakes

Grilled fish, steamed greens and brown rice

Warm millet / quinoa salad with rocket, grilled chicken, spring onions and fresh herbs,

Yellow mung bean, carrot and butternut squash soup with turmeric, cinnamon and cumin

Mashed potato / root vegetables with olive oil, coconut cream, garlic and herbs

Baked polenta with ratatouille

Baked fruit stuffed with raisins / dates / nuts and live yoghurt

Chicken soup / casseroles / stews

Dahls with all pulses, grain and green vegetables

 

 

 

 

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.

 

Does Acupuncture help you conceive? Results from 18 months of fertility acupuncture in Norwich

Here is a summary of the outcomes of female fertility clients seen in the last 18 months.

All maintained terms of treatment – regular acupuncture 2-3 times per month for up to 12 months.
All were with partners whose sperm sample came back within normal range.

The women themselves had a variety of underlying conditions – mainly hormone imbalances such as those found in PCOS, raised FSH and low AMH levels suggesting ovarian reserve was low. Some women were simply non-specified subfertile. Included are women who may have unsuccessfully undergone IVF treatment previously

None had been diagnosed with a blockage in either oviduct.

None were also using Clomid at time of acupuncture.

 

                                           Pregnancy rate           No pregnancy          Miscarriage rate
Women aged 35 and under               100%                            0%                             0%*
Women aged 36 and over                    50%                           50%                            0%*

*as far as is known. Most women continue with acupuncture throughout the 1st trimester.

Length of acupuncture treatment before positive pregnancy test ranged from 2 – 10 months.
Not included in this sample are women who started acupuncture but choose to discontinue for unknown reasons.

So the results look promising! I notice that the common link between all the woman who do fall pregnant whilst using acupuncture is their long term commitment to changing the environment within their body – They implement lifestyle and dietary changes that I suggest, they observe the changes in their menstruation and they stick to the regular acupuncture sessions. In short they take charge of their fertility and it is them – not the acupuncture who ultimately are responsible for their positive result.

Acupuncture and Womens’ Health

Women often first visit me with their chief complaint being pain around the time of menstruation. Most of us accept a small amount of tension in the lower abdomen as normal and can even welcome mild uterine cramping as a signal that the body is working as it should, ready to release a build-up of emotional and physical tension. However for some women the pain is unbearable – and often is due to underlying gynaecological factors. Primary dysmenorrhea – (pain with no underlying complications) is often helped by combining gentle exercise and a couple of acupuncture sessions in the 12 days leading up to the onset of bleeding. The women I see often report an easing of other premenstrual related issues such as headaches and heavy limbs.

Most commonly the past year I have seen women suffering with endometriosis which can cause pelvic pain throughout the cycle but particularly bad at ovulation and menstruation. I often see women frustrated and exhausted after finding the conventional approach of contraceptive pills and pain killers is simply not providing relief. Regular acupuncture sessions combined with dietary advice can yield fantastic results in a very short time. I tend to needle points on the lower abdomen, using an infra red heat lamp overhead to warm and relax the tissues – often there is immediate relief as the circulation is improved and local parasympathetic activity encouraged.

The third most common type of pelvic pain I see in the acupuncture clinic – is symphysis pubis dysfunction (SPD), often triggered in late pregnancy. Very few needles are inserted into the fleshy parts of the hips and legs to affecting the pelvic girdle nerves.

Chinese medicine has a long history of addressing women’s health issues – encouraging us to use each menstruation as a guide to our inner wellbeing and overall health. For an acupuncturist each cycle gives a summary of how a woman has lived her life in the previous weeks, a reflection of both physical and emotional activities. It really is an incredible tool to for the physician to use in understanding each woman as unique – as each cycle can vary wildly in its nature from month to month.

Acupuncture can be used safely alongside conventional medicine and poses very few side effects. If you are considering acupuncture arrange to discuss with Kate or your GP as to whether it is suitable for your condition.