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 a conception. There are other important considerations, for example aging fertility, and or stress may negatively influence time to conception.
Reasons for utilization 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 utilized, 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 utilized over the recent years. Gamete Intra-Fallopian Transfer (GIFT) is rarely utilized as an assisted reproductive technology for couples (in our area) - so we do work less in comparison with patients undergoing these technologies.
Acupuncture helps women feel less anxious and stressed about their difficulty 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, especially for the women that request support.
Current research issues
With regards to the existing scientific evidence base of acupuncture alongside IVF, there is now a recognized need for good, preferably high quality randomized controlled trials. For example, a systematic review of twenty randomized controlled trials found that trials of acupuncture adjunct to assisted reproductive technology were all of low methodological quality. Women in these research trials had limited acupuncture. Acupuncture consisted of one-three sessions, at an advanced stage of their medical fertility treatment. In other words, no acupuncture treatments were administered in preparation for assisted reproductive technology, during pretreatment (down-regulation) or sufficiently during ovarian stimulation.
When to have acupuncture
Acupuncture treatment should not be focused at embryo/blastocyst transfer only, acupuncture should be (when possible) administered prior to assisted reproductive technology, and frequently administered during ovarian stimulation (as acupuncture has been hypothesized to benefit several important processes regarding folliculogenesis and egg maturity). As well as post transfer. These factors are congruent to prior events necessary with regards to implantation potential. Professional acupuncture should also be provided to patients only after an acupuncture consultation and diagnosis that is monitored for treatment effects and reviewed.
Research recommendations acupuncture for IVF/ICSI
If you would like information on how to design an effective acupuncture intervention within a randomised controlled trial 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. See Lianne's excerpt below: