Diagnostic indications of subfertility
Subfertility is broadly defined as either an inability to conceive after one or one-two years of frequent unprotected sexual intercourse. Frequent unprotected sexual intercourse should occur at regular intervals at one to three days in the woman’s fertile window.
The more frequent unprotected sexual intercourse is (every one-two days), the more likely it is to result in conception. There are other important considerations when considering time-to-conception delays such as aging fertility, and or stress may negatively influence time to conception.
Reasons for utilisation of assisted reproductive technology
In the UK male factor subfertility is the most prevalent condition leading to the use of assisted reproductive technology. The next reason is unexplained subfertility, i.e. non-medically identified. There are other less prevalent conditions where assisted reproductive technology is utilised, tubal factor disease, in some cases of endometriosis or hormonal disorders.
We provide a specialist and advanced acupuncture service to help couples trying to conceive naturally or for couples that are undergoing assisted reproductive technology including IVF/ICSI, Frozen Transfer (FT), third-party sperm donor or egg donor cycles.
We also work with women that are having ovulation induction usually over a 3-month period. However, intrauterine insemination (IUI) has become less utilised over the years BUT there is a very recent trend to the reintroduction of IUI (NHS) recognised in different trusts.
Acupuncture can help men and women feel less anxious and stressed about their difficulties conceiving, medical fertility treatment processes or their experience of fertility treatment obstacles.
Our fertility acupuncture specialist Lianne Aquilina has conducted work in the area of the psychological impact of subfertility and fertility treatment and uses acupuncture to help to reduce fertility-related anxiety, stress and depression.
With regard to the existing scientific evidence base of acupuncture alongside IVF, there has been a recognised need for preferably high-quality randomised controlled trials. For example, back in 2013 a Cochrane systematic review of twenty randomised controlled trials found that past historical clinical trials of acupuncture adjunct to assisted reproductive technology were all determined to be of low methodological quality.
As research developed over the years various problems with research processes as well as positive differences have been identified in the design components of randomised controlled trials and more recently the systematic review process.
For current up-to-date information regarding IVF or ICSI and acupuncture research please click here. Scientific research on acupuncture for IVF is currently classified as "inconclusive" in our view. This means that more research is required for integration and implementation into medical settings alongside "routine" care. Research does indicate that acupuncture treatment can help women to achieve a clinical pregnancy, live birth and is supportive for the emotional wellbeing of people experiencing subfertility.
Professional acupuncture should only really be provided to patients after an acupuncture consultation by a professional qualified acupuncturist that is a member of an appropriate regulatory organisation, and has postgraduate training in the field of fertility. In the UK the regulatory body for acupuncture is the British Acupuncture Council (BAcC). Acupuncture treatment should be dynamic in response to the patient's case history, monitored for effect, modified accordingly, and reviewed. It is recommended if possible that patients are supported in other aspects of their medical treatment especially ensuring that this patient group is well informed about medical treatment decisions made on their behalf.
A public website aims to provide information in the fertility sector and is a good place to start to learn more about assisted reproductive medicine in the UK. It must be noted that some information regarding evidence base maybe out of date due to delay in updates, and .the nature of data collection. You can contact this authority direct through the freedoms of information act. Click here.
Research Recommendation Acupuncture for IVF/ICSI RCT
If you would like information on how to design a high-quality acupuncture intervention within a high-quality randomised controlled trial design contact Lianne Aquilina. Lianne has a Master of Science in Applied Health Research and produced a research proposal for a randomised controlled trial of acupuncture for IVF with the support of professors of research. See Lianne Aquilina's excerpt below: