Acupuncture for IVF
Acupuncture is the most commonly used complementary treatment alongside IVF treatment and its impact has been well researched. My focus is to help you understand the process and work alongside any fertility treatment you may be receiving, so you feel supported and in the best possible position to navigate the journey.
How can acupuncture help IVF?
Research suggests that acupuncture may increase implantation rates through:
• regulating stress hormones that affect implantation
• modulating neuro-endocrinological factors (regulating hormone levels)
• increasing blood flow to the uterine lining
• modulating cytokines and immune response
When should I start? How often do I need acupuncture during IVF?
Research shows that acupuncture on the day of the embryo transfer significantly increases the success of IVF. While support on the big day is crucial, ultimately the outcome of IVF depends on the quality of the eggs, sperm and the resulting embryo.
It is the experience of most acupuncturists and their patients that a 3 to 6 months period of preparatory treatment before an IVF cycle can increase the success rate. Follicles that contain eggs take over a year to develop, while the last 3 months of their development ovarian follicles grow tiny blood vessels and from this point on nutrients and hormones in the blood supply can affect follicular development.
The following stages give an idea of the ideal timings of acupuncture treatment when used alongside IVF treatment and the purpose of treatment at each stage.
Preparation Phase
Acupuncture during this preparation phase aims to improve blood circulation to the uterus and ovaries, regulate the menstrual cycle, support efficient and regular ovulation and address any underlying imbalances.
These sessions are also an opportunity to ensure optimal nutrition, discuss supplements, understand the road map of moving through a treatment cycle and gather any other tools that will be useful along the way. An initial consultation will assess where you most need support and I will be able to advise on the approach to treatment and approximately how many sessions are needed, usually weekly or fortnightly.
Down Regulation (Long Protocol) or Before the Period (Short Protocol)
At this point an acupuncture treatment in the week before a bleed is focuses on ensuring an efficient elimination of the womb lining. Producing a full clear-out of the old endometrium allows the best opportunity to develop a fresh, healthy and thick lining with good blood flow. Treatment may also be used at this stage to reduce the potential side effects of down-regulation such as headaches or hot flushes.
If you are on the short protocol (and are not taking down-regulation medication), the principle is exactly the same – to try to achieve the best shedding of the old lining to make way for the new.
Stimulation
During the stimulation phase follicles start to develop in the ovaries and the womb lining starts to build up again. The medications are targeting the ovaries to produce multiple mature follicles. Acupuncture helps to increase response to stimulation medication by improving ovarian and uterine blood flow. Acupuncture during ovarian stimulation may help to increase the number of retrieved eggs and increase endometrial thickness. Typically patients are seen twice during this phase.
Egg retrieval recovery phase
Most patients do not need any treatment during this time. However, some women who experience complications during or after the egg retrieval procedure, for example, pain or symptoms of mild to moderate OHSS, may benefit from additional acupuncture treatment during this time. Please note, severe OHSS requires immediate hospitalization. If in doubt, call your IVF clinic’s emergency number or go to A&E.
Embryo Transfer Day
Acupuncture around the time of transfer has been shown to increase pregnancy rates and this is the time that many patients have heard of and that much of the research focuses on. While research often uses protocols delivered 25 minutes before and after the transfer, in my experience there is no need to be too rigid and treating within 24 hours of embryo transfer is often just as effective.
The purpose of the treatment is to increase blood flow to the womb lining in order to increase receptivity, and to reduce any uterine contractions or spasms that may occur due to the transfer procedure itself. At this point treatment also works to regulate stress hormones which affect implantation, reduce anxiety and calm the mind.
2 week wait
There isn't any evidence that having acupuncture during the ‘two week wait’ post-embryo transfer increases implantation rates. However, this is a very stressful period and if anxiety levels are high, acupuncture may be used to help relax and make time for your experience. Acupuncture treatment during the implantation phase aims to ‘calm’ the uterus, regulate the immune system, reduce stress levels and help improve blood circulation.
Ideally, once a positive result has been achieved, treatment until week 12 of the pregnancy is recommended in order to maintain balance and ensure the pregnancy progresses smoothly.
Pregnancy Support; as required
Most pregnancies progress without complications. However, IVF pregnancies are at a slightly higher risk. I generally recommend patients continue with acupuncture during the first trimester, weekly or fortnightly. These sessions can be used to mitigate symptoms that can arise in the first trimester (nausea, fatigue, morning sickness). Patients whose pregnancies are considered to be low risk are usually discharged at 12 weeks gestation. Patients who have high-risk pregnancies are advised to carry on with acupuncture treatments on a less frequent basis. Every 4-6 weeks is sufficient in most cases. Read more on acupuncture supporting pregnancy here.