What to say (and what not to say): Holiday Edition

The holidays can be hard for those struggling with infertility. In addition to encouraging anyone in the midst of their journey to create healthy boundaries, say no, and even consider a new holiday tradition if your current plans are too triggering, we’d like to offer something to the friends and family of those struggling (or, honestly really anyone because somethings should just not be asked about!).

First and likely most important: Don’t ask pregnancy related questions. It’s never ok to ask someone if they are trying for a baby. This question, while so painful for many, is just too personal! Can you imagine asking an equally personal question to your cousins/aunts/etc? We like a response with a gentle, but firm comment drawing attention to that question like “Wow?! That is a really personal thing to ask me!” Hopefully this will help stop further conversations like this.

Second, offer love and support on their terms. This suggestion is more for people who know about your journey. Let them determine what kind of support they need and, above all else, offer love.

Third, respect their boundaries. This just isn’t about you. It’s about protecting themselves during a really delicate time. Please don’t make it about you (see number 2, offer love). If they can’t stay for the whole gathering, or just can’t be around the couple that just can’t stop taking about their pregnancy, that’s ok. Boundaries are healthy.

Fourth, be mindful of conversation topics. I know that in a group of parents, conversation often revolves around kids and families, as it is often what occupies the majority of your time. But, if you have someone in your group that doesn’t ‘have a family (whether they are trying, not trying, wanting a family or not) make sure you move conversation to a different topic. Trust me, they will be so grateful!

Fifth, it’s ok to just hold space for someone who is struggling. They usually don’t want advice and saying “it could be worse” never comes off well. It’s ok just to say “that sounds awful. I am so sorry” and then just be with them or even ask how they need support. If you are feeling at a loss here, this video might help.

Sixth, if you know someone that is struggling, just ask them what they need. They might want to recount stories from the good ol’ days to get their mind off of it. They might want to talk about their feelings or their journey. They might want a wingman to help deflect questions from Aunt Susan. I’m sure, even if they don’t need anything, knowing you’ve got their back will make their holidays a little brighter.

Seventh, basically a repeat of number 4, but we wanted to reword this advice in another, more direct way. If you know someone is trying or even struggling, ask them about their job, hobbies, interests, literally anything else. They likely want social interaction and would love to be asked about anything other than their pregnancy status.

Eighth, last and definitely not least, don’t ever analyze anyones food choices to see if you can ‘figure out’ if they are pregnant or not. This behavior is annoying at best and intrusive at worst. You will find out soon enough and it is really none of your business. Someone might not be ready to share if they’ve previously had miscarriages or didn’t get great news at their last ultrasound. They also might be watching their diet or not drinking alcohol to prepare for a cycle or maybe they just want to be healthier and it has nothing to do with pregnancy or fertility. They might want a second helping of potatoes because they are eating for two, or they are just hungry and love potatoes! Again, this is none of your business unless you want your choices to be open for questioning.

Our Guide To Tracking Your Cycle

By Sarah Prater
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Acupuncture, Cycle Tracking, Fertility, Ovulation

A photo of a woman looking at a calendar with the words "Ovulation Tracking: Putting it All Together" across the photo. @TNfertilityacu is noted at the bottom. — Tracking your cycles can help optimize intercourse timing and even help clue you in to issues impacting your fertility.

Our bodies are constantly giving us clues as to what is happening on the inside! By observing changes in our bodies and tracking our cycles, we can have a better idea when ovulation might be happening. ⁠We encourage our patient to track their cycles using a method they feel comfortable with that doesn’t add any undue stress to the journey.

Tracking your cycles can optimize intercourse timing, and even help screen for any possible ovulation or luteal phase issues that might warrant a referral to a reproductive endocrinologist. We’ll go through our top three cycle tracking methods to help give you an idea of what to look for and where to start.

There are lots of apps that can help you track this information over time so you can start noticing patterns, symptoms, or even red flags that might develop.

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Cervical Fluid Tracking

Cervical fluid or mucous will change throughout the cycle and, by observing these changes we can get an idea of when our our fertile window starts and when it might end. In a nutshell, your cervical fluid will be thick and more viscous (we describe it almost like lotion) during non-fertile times. This mucous can often stay in the vaginal canal and might not be noticeable without an internal check. When we’re approaching ovulation, the fluid will become thin, watery, and almost egg-white consistency to allow the flow of sperm through the cervix. After ovulation, it will become thicker again.

4-6 days prior to ovulation, you’ll notice cervical fluid increasing. It will be wet, thin, slippery, and usually clear. Typically women will report an increased feeling of “wetness.” ⁠
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In the 2-3 days leading up to ovulation, our cervical mucous takes on the consistency of raw egg white. If you were to have some on your fingers and pull them apart, the fluid would stretch between them. (There are lots of examples online of what this looks like). ⁠
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After ovulation has occurred, cervical fluid becomes thicker, sticky, and more dry. You might not notice any or you might see some thicker, creamy fluid.⁠
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Cervical mucous helps to prevent anything from getting into the uterus most of the month, but during ovulation, it becomes fertile allowing sperm to travel through the cervix, into the uterus, and up into the fallopian tubes where conception happens. ⁠One example, that Cleveland Clinic uses, that we think is helpful is to think of the uterus like a swimming pool. Sperm have a much easier time swimming in thin, watery fluid vs thick, creamy fluid.
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We recommend checking your cervical mucous daily for a couple of months to see what patterns your body has. Semen can make this a bit harder, to try to check with that in mind. ⁠Cervical mucous can also be affected by some medications as well as dehydration.

Ovulation Predictor Kits

Ovulation predictor kits, or OPKs, are the most common way our patients track their cycles. We like them a lot as they are usually easy to use and give you some warning that ovulation is coming so you can plan intercourse accordingly.
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First off, OPK’s measure the level of luteinizing hormone present in your urine. Levels of LH peak 24-48 hours before ovulation. ⁠
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When you start using them, you’ll want to err on starting them a little earlier in the cycle until you get an idea of when you typically ovulate. To calculate this approximate range, take your average cycle length and subtract 14 days. This is your “calendar method” ovulation date. (which is not always accurate). From here, you’ll want to start your OPK’s about 4-5 days before this date. So, if you have a 32 day cycle, you’ll take 32-14= 18. 18 is. your “calendar method” date. You’d want to start your OPK’s around cd 12 or 13 to start. Once you get an idea of your normal ovulation date after a few cycles of testing, you can start testing 2-3 days prior to your anticipated ovulation. After you get a positive test, you can stop testing. ⁠
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If you have irregular cycles, we typically recommend testing starting around cd 8-9 to start and then testing until you get a positive. Of course, as you get to know your timing, you can adjust this date accordingly. It is possible that you have anovulatory cycles or ovulate irregularly and OPK’s can help determine what might be going on. If you notice any of these patterns, we recommend a visit to the reproductive endocrinologist to find out what might be causing the issue.
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Try to take them everyday at the same time. For most women, this will be first thing in the morning. You may find another time of day that works for you. You will see a faint line or no line when they are negative. As you get closer to your peak LH levels, you’ll see the line get darker and then finally go positive. From here, you can expect ovulation to happen in 24-48 hours. Positive OPK day is the ideal day to time intercourse and we recommend trying during the 2-3 days following the positive test as well. ⁠
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There are tons of different tests on the market, some are cheap strips that are dipped in a small cup of urine, others are digital and some even combine with an app to give even more information. For most folks, we recommend starting with the cheaper strip type tests. The digital tests can be quite expensive especially if you are taking them often, but some women prefer them over the others. All work well, so choose what works for you.

Basal Body Temperature

Basal body temperature (BBT) tracking can be another great way to track your cycles and get a bit of information to help you time intercourse and even help determine if your cycles are healthy or you need to make an appointment with your reproductive endocrinologist. ⁠
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BBT tracking involves using a basal body thermometer each day at the same time (even on the weekends!) and tracking that number over time. Early in the cycle, prior to ovulation, temperatures will be low. ⁠
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Around ovulation, you might notice a drop in temperature followed by a ~1 degree rise that can take place over the course of 1-3 days. This temperature rise indicates that ovulation has happened and is caused by increased progesterone levels in the body. After ovulation, temps should stay high and will drop about 24 hours prior to menstruation.
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Using BBT in conjunction with OPK’s and fluid tracking can help mark the beginning and end of your ovulatory phase. Cervical fluid will become more fertile in the days leading up to ovulation, OPK’s will turn positive about 24-48 hours prior to ovulation (your temps will still be low or you might see an ‘ovulation dip’ around this time). Once you ovulate, temps go up (you’ll also see your cervical mucous becoming thicker and more opaque) and this marks the end of your fertile window.
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If you don’t see a bi-phasic chart (meaning a chart with a clear temperature rise and a low temperature phase and a high temperate phase), and your numbers look a bit more random, you might want to schedule a visit with your doctor to confirm ovulation and rule our any underlying conditions. ⁠
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It can take some time to get used to temping and reading your chart, so give it 2-3 cycles to get used to your patterns. There are countless apps that can help you track the data and most will help identify your ovulation date as you go.
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BBT tracking can be helpful in the acupuncture clinic as well. We can use this information to track certain cycle points over time and it can help guide our treatment. ⁠
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However, we’ve seen many patients who find this data overwhelming and tracking stressful since it has to be done daily. In this case, just don’t do it (or maybe just do it for a few cycles). You can also stop after ovulation is confirmed, as usually the stress comes from looking for early signs of pregnancy in your tracking data, and start when you begin your next period. BBT isn’t a reliable indicator of early pregnancy.

One piece of advice on BBT tracking: Please don’t try to analyze the data day to day. There are many things that can affect your temperature (a colder or warmer room, alcohol consumption, insomnia, fever, different sleep pattern, etc). The best way to use BBT is to track the health of your cycles over time.
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As always, we are happy to talk through cycle tracking with our patients and often use this information to optimize the timing of our treatments and the acupuncture points used. If you’d like to make an appointment, give us a call, 865-315-3845 or head to our website and schedule online.

Celebrating Good News: Why We Say What We Say

Something I find myself saying on an almost daily basis is to “celebrate this news in a way that feels right to you.”⁠ ⁠

I want to take a moment to unpack this statement a little bit. Infertility is tough, really tough. Everyone copes with this difficulty in their own way and many find themselves not wanting to get their hopes up for fear of disappointment. This is, of course normal (btw, you don’t have to be ‘optimistic’ for it to work) and cautious optimism can be a great way to support your mental health. However, when good news does finally come, whether it is finally having enough follicles for a retrieval, a lining thick enough for transfer, finding the right medication dosage that seems to support a healthy cycle, or even finally getting news you are pregnant, we think it is so important to honor that moment. ⁠

You worked hard and went though so much to get to this moment and you deserve a small moment of celebration! We encourage couples to take some time and celebrate. This celebration can look different for different families and situations. You may have just found out you were pregnant, but have a history of loss that might make your celebratory moment look a bit different that someone without that history, and that is ok! A simple hug and expressing hope to your partner or a friend can be enough. Maybe you go have your favorite meal or get a bouquet of flowers. It doesn’t have to be much, but honor how far you’ve come in a way that also honors how far you might still have to go. ⁠ ⁠

You will get there, remember to love yourself along the way! 🧡

-Sarah Prater, L.Ac. Tennessee Center For Reproductive Acupuncture

Fertility Supplements: A Guide for Couples Trying to Conceive

By Sarah Prater
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Acupuncture, Fertility, IVF, Postpartum, Pregnancy, Supplements

There is so much information online about what supplements may or may not be helpful for fertility. It seems that almost everyone has an opinion and, if you search long enough, you’ll find story after story that goes like this “I took x for only one cycle and was pregnant after x months!” While these can feel encouraging, supplements typically aren’t the magic bullet for a single cycle. Some can even cause cycle irregularity if used in cases where they are not indicated (I’m looking at you vitex!). The truth is that achieving pregnancy is, like most other things, a journey that involves a healthy diet and lifestyle, appropriate supplements, and possibly treatment from a reproductive endocrinologist in conjunction with other providers as needed.

So, what supplements are helpful? We wanted to break down our most commonly recommended supplements and why they might be helpful so you can talk with your fertility team about what is best for you.

This list of supplements comes from Theralogix and we chose this particular company because of their high standards and focus on researched backed supplements. All of their supplements are dye free, dairy and gluten free. They have clean labeling, so you’ll never get an ingredient you aren’t expecting. And they are third party certified by NSF International.

Links to product pages below include our PRC discount code (137923) for Theralogix so you can be sure you are receiving the best pricing. The PRC code (137923) can also be entered at checkout to receive the discounted price. We do receive some compensation for sales generated through these links.

Prenatal Vitamins

I’m sure you expected this one, but a good prenatal is always recommended for all women trying to conceive. Prenatal vitamins contain nutrients like folic acid, iron, and others that work to make sure your body’s nutrient profile is optimized for pregnancy which can help support fertility as well as help your body be ready when you finally find success.

Getting a good quality prenatal vitamin is essential. We recommend Theralogix brand prenatal vitamins and they have a full lineup of choices from a preconception specific vitamin to their most comprehensive prenatal, Theranatal Complete. Choose one you will take daily, some contain multiple softgels/pills per day which can be hard for some women especially in early pregnancy.

Their line-up includes Theranatal Complete, Theranatal One, and Theranatal Core, a preconception focused prenatal. For breastfeeding mothers, they also offer Theranatal Lactation Complete to make sure you’re getting the nutrients specific for nourishing your baby.

Vitamin D

If we had to name an underdog in the fertility world we’d give it, hands down, to good ol’ vitamin D. A 2017 study showed that women with lower vitamin d levels had a harder time conceiving on their own. Low levels are also associated with poorer outcomes in ART (assisted reproductive technologies). There is even some evidence that lower vitamin D levels are associated with higher rates of preeclampsia during pregnancy.

Men also benefit from good levels of vitamin d. Studies show that healthy vitamin D levels may improve testosterone levels as well as sperm motility.

It is always a good idea to ask your doctor to test your vitamin D levels, as very low levels require a prescription dose and follow up with testing after supplementing for awhile to make sure your levels stay in a healthy range.

Most good quality prenatal vitamins and even Conception XR will have adequate levels of vitamin D, but it might be worth an additional supplement if your prenatal has less than 1000IUs per dose. If you need an additional supplement due to a diagnosed deficiency or your prenatal is lacking, Theralogix has a great stand-alone vitamin d supplement. Please check the FAQ section for possible drug interactions.

CoQ10

CoQ10 is a powerful antioxidant that may improve egg quality and help support optimal chromosomal division during fertilization. CoQ10 helps to improve how the egg cells create energy which can improve cell division and overall egg health. Cells’ ability to create energy becomes less efficient as we age. It may also improve response to ovarian stimulation for some women with poor ovarian reserve.

We recommend this supplement to anyone concerned about ovarian reserve. It is usually very well tolerated. It is not known to be beneficial during pregnancy, so you can stop taking it once you find out your cycle was a success.

There is also evidence that CoQ10 may be beneficial for male fertility as well.

Theralogix makes a highly absorbable CoQ10 supplement that is one of our most popular supplements. Please read the FAQs for possible drug interactions.

Fish Oil

Fish oil, omega three fatty acids and DHA, are found in seafood and have an important role in cells throughout the body. They are an important part of cell walls and membranes and support the receptors, including those that regulate genetic function, in these walls to allow good communication between the cells in the body. They also are the starting point for hormones that regulate inflammation and contractions of artery walls.

For supporting fertility, there is evidence that fish oil can support pregnancy rates for those trying naturally and that it may play a role in reducing miscarriage. It may also increase uterine blood flow and help to regulate the immune system. There is also evidence that fish oil can improve male fertility as well.

Some prenatal vitamins will contain DHA and omega-3 fatty acids, but here is a link to a great standalone supplement from Theralogix.

Fish oil can act as a blood thinner, so please read the FAQs for possible contraindications as well as recommendations around surgical procedures.

Melatonin

This powerful antioxidant is most known for its use in treating circadian rhythm disorders or occasional insomnia, but more and more research is coming out showing that melatonin may be a key player in the development of healthy eggs and embryos.

Research shows that melatonin can help increase the number of mature oocytes (eggs) retrieved, improve fertilization rates, and improve embryo quality for those undergoing IVF. Additionally, pregnancy and clinical pregnancy rates improve with melatonin.

3mg Melatonin should be taken about 30 minutes before bedtime and we recommend stopping it once you are pregnant. It is also not recommended for women trying naturally, as it can impact ovulation. There are some medications (see FAQs) that are possibly contraindicated with melatonin, so please talk with your doctor before starting supplementation.

Ovasitol

Ovasitol contains 2 forms of inositol which provide 4,000 mg of myo-inositol and 100 mg of D-chiro-inositol, in the body’s naturally occurring ratio of 40:1. Inositol is a nutrient found in fruits, beans, grains, and nuts and is also made by the body.

Research shows inositol can balance hormones leading to more regular, ovulatory menstrual cycles. It also promotes healthy ovarian function, lipid levels, reduce insulin sensitivity, and may support better egg quality. In ART, it has been shown to support oocyte development and maturation and improve pregnancy rates.

Ovasitol is recommended for those that have been diagnosed with PCOS. It comes as a tasteless powder that is mixed into the beverage of your choice twice daily. Most of our patients report that it is actually is, in fact, tasteless. If you are taking a thyroid medication, please review the FAQ’s for details on timing Ovasitol.

Male Prenatal

Obisouly, most of this post has focused on supplements for women, but we all know that it takes a healthy sperm and egg to create a healthy embryo. Fortunately, there is a supplement designed just for men. Theralogix Conception XR Reproductive Health Formula is formulate with fertility specific nutrients and powerful antioxidants such as vitamin C, vitamin E, zinc, and selenium, designed to support sperm health. We consider this a “male prenatal” and recommend it anyone trying to conceive or going through IVF, where motility is not a concern.

If there are concerns about motility, we’d recommend the other product in Theralogix’s male fertility line, Conception XR Motility Support Formula. While more expensive, it contains and additional ingredient, L-carnitine, to help support motility. This is a great choice for those with motility issues or anyone trying to conceive naturally, with a medicated cycle, or through IUI.

Please review the FAQs on each page for drug interactions.

While both of these contain vitamin D, they do not contain Fish oil or CoQ10, so we’d add those on to the recommendation for male fertility.

Contraindications

With any medication, supplement, or herb, there is always the possibility of a drug interaction. Please review the FAQ page for each supplement for an overview of drug interactions and other contraindications and always talk with your doctor before starting any new supplement. It also a good idea to review supplements with your team prior to starting a new cycle as well.

References:

https://www.fertstert.org/article/S0015-0282(17)30420-X/fulltext

https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-017-1408-3

https://www.ccrmivf.com/blog/how-vitamin-d-may-impact-your-fertility/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5870379/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6516448/

https://pubmed.ncbi.nlm.nih.gov/21154195/

https://www.ccrmivf.com/blog/fertility-benefits-omega3-fatty-acids/

https://onlinelibrary.wiley.com/doi/10.1002/fsn3.3464

https://www.sciencedirect.com/science/article/pii/S0753332221007848#:~:text=Melatonin%20plays%20an%20important%20role,assisted%20reproductive%20technology%20(ART).

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5097808/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8226917/

Subchorionic Hemorrhage: What are they and what you need to know

Subchorionic Hemorrhage

Lately we’ve had a few patients with subchorionic hemorrhage come through our office doors. We wanted to take a moment and share what SCH is, what do if you have one, and how acupuncture might be able to help.

First, what is a SCH?

A subchorionic hemorrhage is a collection of blood between the chorion (the outermost membrane that surrounds the fetus) and the uterine wall. It is a common cause of vaginal bleeding in early pregnancy, affecting up to 20% of women. Most subchorionic hemorrhages are small and go away on their own without any problems for the pregnancy. However, larger hemorrhages can increase the risk of some complications. The exact cause of subchorionic hemorrhages is unknown, but they are thought to be caused by a tear in the chorion.

Second, what should you do?

Any time you have any bleeding in pregnancy, your first call should be to your OB or RE. They can run some blood work and do an ultrasound to make sure your pregnancy is healthy and rule out miscarriage. They may recommend additional progesterone, bed rest, pelvic rest, or other treatments.

Third, how can acupuncture help?

To be clear, acupuncture should never be used in lieu of treatment from your doctor, we always recommend an integrative approach. There is evidence that acupuncture combined with progesterone can “improve the effective rate of patients with threatened abortion in early pregnancy complicated with subchorionic hematoma, regulate immune factors, promote the hematoma absorption, and has a better synergistic effect” with progesterone. It can also help alleviate anxiety as any bleeding during pregnancy is terrifying!

If you have questions, feel free to give us a call, 865-315-3845 or email us at info@TennesseeReproductiveAcupuncture.com, we’re always happy to help!

Fertility Myths: Separating the Truth from Fiction

Friends, family, and the internet are full of well-meaning advice meant to help those trying for a child. However, much of this information is, at best, a well-meaning half truth. We took a few of the most common fertility myths we come across and tried to break them down.

You have to wait one year to see a fertility doctor:

This advice encouraging couples to wait one year assumes they are under 35 and that the female partner has regular cycles. If you have irregular cycles, are over 35, have a history of endometriosis, PCOS, etc please contact your doctor sooner than one year. We’ve seen so many couples wait the “recommended year” while they only have 2 periods in a year, etc. Early testing and interventions can reduce months of heartache and get you on the correct treatment path sooner. When in doubt, check with your doctor to see what they might or might not recommend. One caveat, there are some insurance companies that will not pay for fertility testing until the couple has been trying for a year, so do your due diligence to avoid an unexpected medical bill.

A fertility clinic will always recommend IVF

There is such a stigma around seeking help from a fertility clinic. This stigma, fortunately, is a huge myth! Going to a see a reproductive endocrinologist (aka fertility doctor) will ensure that you get the best testing at the right times to get to the root of your issue. Once you have arrived at your diagnosis, a treatment plan will be presented to you that might start with monitoring a cycle, medication (while trying on your own at home), surgery, IUI, and in some cases IVF. You’ll have the opportunity to discuss this plan with your partner, doctor and even get a second opinion to make sure you’re getting the best care possible. There are so many treatment options prior to IVF for most couples.

We believe knowledge can empower your treatment decisions and know that it can help us determine what acupuncture can and cannot do for you. In addition, once you are pregnant, fertility clinics will monitor your blood levels immediately and re-run those tests frequently to address any issues as early as possible and give you peace of mind during the often stressful first few weeks of pregnancy.

If you are under 35, you won’t have fertility issues

Yes, fertility declines with age and women see a biggest drop after 35. Men also see a less pronounced decline in fertility with age. If you have been having unprotected sex for over a year, have irregular cycles, or other concerning symptoms or relevant medical history, please seek out the care of your OB/GYN or make an appointment with a reproductive endocrinologist. On the flip side, being over 35 does not mean you don’t have a chance of getting pregnant. Many of our patients are over 35 and many go on to become pregnant.

Infertility is the women’s fault

First off, I hate the word fault. We’d never use that word to describe any other health condition, so let’s throw that out right now. Secondly, male factor infertility accounts for 1/3rd of all infertility cases. Female factor accounts for another 1/3 and a combination of male and female account for the other 1/3. In fact, one of the first tests your doctor will (or should) run is a semen analysis. A full diagnostic workup by a reproductive endocrinologist can help pinpoint your issues and guide appropriate treatment.

Ovulation always happens at cycle day 14

It is often assumed that ovulation always occurs at cd 14, but this couldn’t be further from the truth. Ovulation can vary from woman to woman and even from cycle to cycle. Medications, stress, illness, etc can change the timing of ovulation as well. We recommend tracking your cycles with one of the many apps on the market and using ovulation predictor kits to determine when your ovulation occurs. Timing intercourse at the wrong time can be a reason a couple isn’t becoming pregnant.

If you just relax….

Stress DOES NOT cause infertility. We always tell our patients that if stress caused infertility, no one going through fertility treatment would become pregnant. What is true is that infertility causes stress. It is also linked to higher rates of depression and anxiety. This journey can be long and tough. It is important to take care of yourself so you can be your best self throughout the ups and downs. Acupuncture can help to reduce stress, which we see as a way to support our patients on this journey. We also recommend seeking the support of a therapist who specializes in infertility to help you navigate this time in your life.

Why We Recommend Theralogix

By Sarah Prater
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Clinical, Fertility, IVF, Postpartum, Pregnancy, Supplements

One thing we often get asked about is supplementation and herbs to support fertility. While not every supplement is appropriate for every patient or in every situation, we often suggest some supplements to help support your fertility journey. For instance, being on a good quality prenatal is always recommended while trying to conceive.

At The Tennessee Center for Reproductive Acupuncture, the brand we recommend the most is Theralogix. We wanted to take a moment and share why this company does a great job with their supplements and specifically supplements for fertility. As always, please consult your medical doctor before starting any supplements. The following comes from Theralogix’s website:

1. Medical Advisory Board Oversite

The Theralogix Medical Advisory Board (MAB) is a multi-disciplinary group comprised of physicians, nationally reputed scientists, and faculty members from leading U.S. medical schools. Each product formulation has been approved by the MAB after detailed review of the scientific data.

The MAB continues to meet regularly to conduct extensive reviews of scientific research and to offer guidance on improving existing formulations or developing new products.

2. Research-Based Formulations

Theralogix will never sell a product that is not backed by solid scientific evidence. That is our promise to you.

3. High Quality Ingredients

Theralogix works in conjunction with top manufacturers to source the highest-quality ingredients for our products. Theralogix often specifies the raw material to be sourced, typically because we believe there is an advantage with a specific raw ingredient in quality, performance (bioavailability or other performance measure), or because a material is used in supporting research.

Whenever possible Theralogix will disclose the specific supplier of key raw materials on product labels. All raw materials must meet the sourcing and testing requirements of the NSF International Certification program. Theralogix will not source any ingredient that cannot be tested, identified, or that is not standardized.

4. Current Good Manufacturing Practices

Theralogix products are produced by the highest-quality, U.S.-based manufacturing facilities under conditions that exceed the Current Good Manufacturing Practice (cGMP) standards set forth by the FDA.

cGMP refers to the Current Good Manufacturing Practice regulations enforced by the Food and Drug Administration (FDA). cGMPs assure that manufacturers follow proper design, monitoring, and regulations when producing dietary supplements. Adherence to the cGMP regulations assures the identity, strength, quality, and purity of nutritional supplements.

5. Independent Testing and Certification

It is important to know precisely what is in the supplement you choose to take. To achieve that assurance, Theralogix works closely with NSF® International, a not-for-profit organization that is the world leader in standards development, product certification, education, and risk management for public health and safety.

NSF certification guarantees that the product contains exactly what is stated on its label, that there are no contaminants or other ingredients that are not listed on the label, and that cGMPs established by the FDA have been met during the production of the product.

Since our founding in 2002, every eligible Theralogix product is tested and certified through the NSF International Dietary Supplement Certification Program.

In addition to certification and testing by NSF International, Theralogix also voluntarily submits its products that contain fish oil for further testing. International Fish Oil Standards (IFOS)tests for contaminants and heavy metals such as mercury, lead, and polychlorinated biphenyls (PCBs). The fish oil used in our products is certified sustainable by the Marine Stewardship Council (MSC).

6. Transparent Labeling

Theralogix follows a clean label policy. All products are artificial dye-free, gluten-free, and contain no proprietary blends or undisclosed ingredients. We strive to reduce or eliminate excipients as much as possible within our production process. Theralogix bottles are made with materials that are recyclable.

7. Clinical Trials

Theralogix products have been used in over a dozen clinical trials conducted by esteemed universities and research institutions across the United States. Several of these clinical trials have been funded by the National Institutes of Health (NIH), one of the world’s foremost medical research centers.

Our products have been chosen for use in clinical trials because of their high-quality ingredients and verified content-accuracy. We are truly honored to be trusted by so many of the country’s leading research institutions.

8. Our Nutrition Experts

Nutritional Science is the core of our company. From our Chief Scientific Officer to our registered dietitians, we are here to help you achieve optimal health. We strive to ensure our science-based formulations will deliver the highest-quality nutrients to support your individual needs. For answers to your nutrition questions, please call 1-888-899-3899, ext. 2 to speak with one of our registered dietitians.

Please use our PRC Discount Code to receive Theralogix’s best pricing. We receive a small commission from every sale using our PRC code.

Mask Policy Update 2022

We would like to announce that we are changing our mask policy.

We feel that, after being masked in the clinic for two years, current COVID-19 conditions, and a fully vaccinated and boosted staff, warrant a change in our policy. We are no longer requiring masks in the office. What does this mean for the clinic?

While we are lifting our previous mask policy, masks are still available to anyone who prefers to wear one; and all of our staff and providers are more than happy to mask upon request.

While masks will not be required we are continuing our cleaning, sanitizing, and hand washing practices and will revisit our policies as needed.

If you have any questions please feel free to reach out to us at any time.

Updated COVID-19 Policy 2021-2022

TN Center for Reproductive Acupuncture COVID-19 Policy:

Clinics will remain closed during any stay at home mandated by local or federal government with exceptions made on a case by case basis. We will follow any and all local and/or federal guidelines with respect to elective medical procedures.

Employee Policies:

Each employee must wash hands when arriving for their shift and before and after any amount of patient contact.
Each employee must wear a mask during their shift.
Self assess health before arriving at the clinic and do not report to work if you:
1. Have a fever over 100.4 degrees.
2. Have any COVID symptoms.
3. Have been exposed to COVID-19 and are symptomatic. If you are asymptomatic:
  1. Vaccinated employee: You may return to work after a negative test
  2. Unvaccinated employee: required to quarantine per CDC guidelines.
Follow any updated CDC, local, or federal guidelines not covered by this document.
Minimize time patients spend in the waiting area.
All Employees and sublet tenants must be vaccinated by 1/1/2022. Exceptions only allowed on a case by case basis following CDC guidelines. Exemption requests must be submitted in writing with necessary documentation. Regular COVID 19 testing may be required.

Cleaning protocols: during the COVID-19 outbreak, strict cleaning protocols are to be followed:

All surfaces used are disinfected with a COVID approved cleaner after each patient. This includes but is not limited to:
1. Treatment room door knobs
2. Table and face cradle
3. Call buttons
Sheets are washed with Tide detergent on a hot cycle and changed in full between each patient
These and any other shared items must be disinfected with alcohol after every use and at the beginning and end or shift or before and after another staff member uses them:
1. Phone.
2. Ipad (also to be cleaned after each use by a patient)
Wipe down these and other commonly touched surfaces with a COVID approved cleaner at least daily:
1. Reception desk
2. Bathroom
3. Front door knobs/closet door knobs
4. Kitchen and other staff areas

Patients will not be seen if they:

Have been exposed to COVID-19 in the last 14 days
1. If they are vaccinated and asymptomatic, they can be seen with a negative COVID test
Have a fever over 100.4 degrees, or other COVID-19 symptoms
Refuse to abide by clinic policies

Clinic Policies:

Patients are asked to arrive on time for their appointment to minimize time in the waiting room.
Patients are asked to come alone to their visit unless they are accompanying a minor or on case by case expectations for other circumstances.
Patients and guardians are required to wear a cloth mask during their visit.
Patients and guardians are asked to wash hands with soap and water immediately upon arriving for their appointment.

When Should I Start Acupuncture for My IVF Cycle?

Acupuncture and IVF: When to start treatment

As you know by now, acupuncture makes a great compliment to an IVF cycle and can help improve pregnancy rates, and reduce miscarriage rates. But is there an optimal time to begin treatment? Short answer is yes, but the timing will vary based on cycle type and patient diagnosis.

Let’s back up and talk about dosage:

Acupuncture is a therapy based treatment, so it is usually done in a series of treatments to treat various symptoms. Much like exercise, it is best done regularly and frequently. You probably won’t get a six pack by hitting the gym once a month…. Acupuncture is the same way.

Another way to think about it is through the concept of dosing. Say you have a major headache and your doctor recommends 400mg of a medication to relieve it and you only take 50mg. You still have your headache. Does this mean the medication didn’t work? No. Any treatment has a proper dosage for maximum effectiveness and acupuncture is no different. In acupuncture, the dosage is the frequency of treatment. The more severe the symptoms, the more frequent the acupuncture to treat it.

In fertility, the concept of dosing is used to provide maximum benefit during specific times throughout the cycle with consideration for each couple’s situation and type of cycle.

Type of cycle and acupuncture start recommendations:

Retrieval Cycle

4-12 weeks prior to cycle.

The three month window of preconception acupuncture is recommended in cases of low ovarian reserve, poor egg or embryo quality. This window represents the full life cycle of the egg so we consider this an optimal time to use holistic treatments, dietary changes, and lifestyle changes to support your egg health.

One month is typically adequate for other diagnoses like endometriosis, male factor, polycystic ovarian syndrome, etc.

Frozen Embryo Transfer

4 weeks prior to the cycle start. In a frozen embryo cycle, 8-11 treatments before transfer is ideal to optimize results.

Natural Cycle IVF or Mini-stim IVF

4 weeks prior to the start of the cycle.

We refer to these treatments as preconception acupuncture. The treatments are designed to improve blood flow, regulate hormones, and reduce stress in advance of your cycle.

Here is a great Q&A session with the doctors at Long Island IVF and their acupuncturist going over the benefits of frequent treatment leading up to an IVF cycle.

Acupuncture During the Cycle

Once your cycle begins, we will increase our treatment frequency to twice weekly until your retrieval or transfer. For our purposes we consider the “start” when you begin ovarian stimulation medication, estrogen, or cycle day 1 in a natural cycle IVF.

For embryo transfer cycles, whether fresh or frozen, we will see you around the transfer itself and again 5-7 days after the transfer to support implantation.

All of these treatments work to support your body, help to improve outcomes and keep you comfortable and relaxed during your cycle. In research, these protocols show an increase in pregnancy rates, live birth rates, and a decrease in miscarriage.

For more information or questions on how this might work with your specific cycle, please give us a call, send an email (info@TennesseeReproductiveAcupuncture.com), or schedule an appointment online. We are always happy to help!