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Acupuncture

Pre-Birth Acupuncture: Helping Prepare Your Body for The Best Birth Possible

Here's a quick guide to Pre-Birth Acupuncture
Here’s a quick guide to Pre-Birth Acupuncture

If you’re nearing the end of your pregnancy, you’ve undoubtedly spent many hours day-dreaming about the upcoming birth of your baby. The last few weeks of pregnancy are a really exciting time! You may have even written a birth plan and discussed your wishes with your doctor or midwife. Many of you will desire to have a vaginal delivery or may even be trying to avoid using any medications during labor and trying to do everything you can to help ensure your birth goes according to plan.

In addition to keeping healthy and active during your pregnancy, there is one more thing you can do in the final weeks of your pregnancy to help encourage a healthy delivery. Pre-Birth acupuncture is helpful in preparing your body and mind for labor and delivery.

 

What is pre-birth acupuncture?

Pre-Birth Acupuncture is a series of 4-5 weekly treatments beginning at week 36 of your pregnancy that are designed to help your body go into labor on time and to labor to progress normally and without complication once it begins. It is not labor induction and will not bring on labor. The baby is in control of his or her arrival date.

Pre-birth acupuncture reduces the need for epidurals, emergency C-sections, and reduces the time you spend in active labor. Overall, vaginal birth rates increase in women who receive these treatments.

 

What does the research show:

  1. Reduces the time spent in the first stage labor (period of time between 3 cm dilated and full dilation) by an average of 2 hours
  2. Reduces the number of inductions in frist time moms by 43% and 35% in all others
  3. Reduces rate of epidural usage by 31%
  4. Reduces emergency C-section rate by 32%
  5. Increases vaginal birth rates by 9%

 

In addition to these benefits, this is a great time to address any stress or symptoms that you might be experiencing in the last few weeks. Acupuncture can be useful for swelling, back/hip pain, acid reflux, headaches, and many other common pregnancy symptoms. We can even use acupuncture to encourage breech babies to turn!

We recommend these treatments as a standard part of our prenatal acupuncture protocol, and many women choose to start prenatal acupuncture in these final weeks to help make their birth plans a reality.

Give us a call with questions or to set up your pre-birth treatments today!

 

References:

https://acupuncture.rhizome.net.nz/acupuncture/research/prebirth/

How We Treat Male Factor Infertility

Acupuncture treatment is helpful in treating many causes of male infertility.
Acupuncture treatment is helpful in treating many causes of male infertility.

Infertility is often seen as something only women have to be concerned about. The reality is that infertility is due to female factors 30% of the time, male factors 30% of the time, and both partners or unexplained infertility 30% of the time.

Male infertility can even go undiagnosed by some practitioners not experienced in treating fertility. A semen analysis should be part of your initial workup with your reproductive endocrinologist. It is a non-invasive, low cost test that can really have an impact on your best course of action.

Common causes of male factor infertility include:

  • Varicocele
  • Infection
  • Hormonal Problems
  • Oxidative Stress
  • Blockage of sperm flow
  • DNA Fragmentation
  • Previous vasectomy

Many times, varicoceles or blockages can be corrected with surgery. Follow up semen analysis will ensure that fertility has been restored. Other causes can be treated with medication or lifestyle changes. Sperm can sometimes even be removed from the testical directly to be used in an IVF cycle in a minor surgical procedure if needed.

Optimizing male fertility is an often overlooked part of a couple’s journey and, yet, there is so much you can do. Various lifestyle changes, complementary medicine, and supplements can have a big impact on male fertility.

ACUPUNCTURE AND MALE FACTOR INFERTILITY

Acupuncture has been used successfully to help treat male infertility. Research studies showed both an increase in the total number of sperm present and an increase in the number of sperm present without structural abnormalities. Acupuncture can also be used to help regulate hormonal imbalances.

At the Tennessee Center for Reproductive Acupuncture, we would like to treat both the male and female partners to help them optimize their fertility. Our recommendations for male factor fertility depend on the timing of the cycle. Sperm go through a 3 month growth and maturation process before they are ready to fertilize and egg. Because of this we like to see men 3 months before their fertility cycle, if possible. However, benefit has been seen from much shorter treatment windows and you can start treatment at any time during your journey. Feel free to call us for a recommendation on your situation.

SUPPLEMENTS TO TREAT MALE FACTOR INFERTILITY

We carry Conception XR supplements for male fertility. There are two versions of this supplement, detailed below. Their primary ingredients are antioxidants and other nutrients shown to increase pregnancy and birth rates and improve sperm motility. As always, please consult with your physician before starting any supplements. The links below will take you to Theralogix’s website where you can purchase your own supply with our discount code already applied. If you need our PRC discount code, it is: 137923

  • Reproductive Health Formula: This formula is designed to support normal male fertility and is recommended for any man trying to conceive. You can think of it as a prenatal vitamin for men! It is also recommended for IVF cycles, when motility support is not necessary.

XR3_300w_300h_sb

  • Motility Support: This formula has an added ingredient, L-carnitine, that is specifically helpful with sperm motility. It is recommended for low motility or when trying to conceive naturally or through IUI or medicated cycles.

XM1_300w_300h_sb

LIFESTYLE CHANGES TO SUPPORT MALE FERTILITY

  1. Smoking has been shown to be very detrimental to sperm health. Please see your doctor about quitting.
  2. Alcohol: Limit to 1 drink per day.
  3. Keep your testicles cool: Avoid hot tubs, laptops on your lap, high temperature work areas, or prolonged baths.
  4. Diet: Increase your fruit and veggie intake and stay hydrated.
  5. Exercise: Aim for 30 minutes of moderate exercise per day.
  6. Harmful supplements: Some supplements containing DHEA or other ingredients, often used for muscle building, can impair sperm development.
  7. Environmental Hazards: Avoid working with radiation, pesticides, solvents, or other fumes when possible.

Sources:

http://www.theralogix.com/sp/theralogix-conceptionxr-motility-support/

http://www.theralogix.com/sp/theralogix-conceptionxr-reproductive-health/

http://www.webmd.com/infertility-and-reproduction/news/20050803/acupuncture-may-improve-sperm-quality

http://www.resolve.org/about-infertility/optimizing-fertility/enhancing-male-fertility.html

Treating PCOS with Acupuncture, Inositol, and Diet

Polycystic Ovarian Syndrome (PCOS) is a common diagnosis that affects approximately 7 million women, although it is thought that less than half of all cases are properly diagnosed. Many women with PCOS will experience some degree of difficulty in getting pregnant and many will use fertility treatments to conceive.

Symptoms associated with PCOS are:

  • Irregular periods or having very long cycles
  • Weight gain (or having a hard time losing weight)
  • Unusual hair loss
  • Hair growth on face or body (hirsutism)
  • Acne
  • Dark Patches of Skin
  • Anovulation (not ovulating)

PCOS is a complex diagnosis and women will not necessarily have all of the above symptoms. Insulin resistance is a common factor in the disease and can lead to the development of type-2 diabetes. Other factors include the presence of multiple ovarian cysts, high testosterone levels, high blood pressure, high cholesterol and high triglycerides. A combination of these factors leads to reduced egg quality, irregular cycles, and infertility.

As you can see, the early detection and treatment of PCOS is extremely important! Luckily, PCOS is generally a treatable condition and responds well to many different types of treatment including fertility treatments. Many, many women with PCOS will go on to have healthy babies.

TREATING PCOS:

ACUPUNCTURE: Treatment with acupuncture has been shown to promote ovulation and, over time, regulate FSH/LH levels back to normal. In one study, a single acupuncture treatment was shown to work as well as an injection of HCG in inducing ovulation. Studies on longer courses of acupuncture treatment have shown a normalization of hormone levels, cycle length, and ovulation. These results could still be seen 3 months after finishing acupuncture treatment. In our clinic, we have seen great results in treating PCOS both for women trying naturally or using some form of fertility treatment.

SUPPLEMENTS: Supplementation with inositol has been shown to promote menstrual regularity and normal ovarian function in women. Additionally, it will reduce insulin resistance, and improve hormone levels. Inositol is a nutrient found in fruits, beans, grains, and nuts. It is also produced by the body. There are a couple of different types of inositol commonly available: D-chiro inositol and myo-inositol. Recent research has shown the greatest benefit from supplements containing a 40:1 of myo to D-chiro inositol. We recommend a supplement with this ratio called Ovasitol by Theralogix for our PCOS patients. It is recommended to take this for at least three consecutive months to see an improvement in hormone levels and menstrual cycles. And continued use will ensure these results continue. As always, please consult with your physician before starting any supplements. Ovasitol can be purchased with our provider discount in the office, through this link. If you need our PRC discount code it is: 137923. 

Ovasitol can help improve fertility in women with PCOS.
Ovasitol can help improve fertility in women with PCOS.

LIFESTYLE/DIET: For many women, diet and lifestyle changes are enough to promote regular cycles. Regular exercise combined with a low-glycemic index diet can help to reduce insulin resistance and regulate the menstrual cycle. Working to maintain a healthy BMI is also helpful with studies showing an improvement of insulin and testosterone levels with just a 5% reduction in body weight. Some women can eliminate any signs of PCOS by working to improve their diet and lifestyle.

A quick guide to low glycemic index diets
A quick guide to low glycemic index diets

So, as you can see, PCOS, while a very frustrating diagnosis, is usually very treatable with very good outcomes using integrative care. Most of our PCOS patients go on to have healthy, pregnancies and healthy babies.

Please call us with any questions. We are very happy to help!

Sources:

http://www.acam.org/blogpost/1092863/185770/Acupuncture-for-Ovulation-Disorders-and-PCOS

http://www.advancedfertility.com/pcos.htm

http://www.theralogix.com/sp/theralogix-ovasitol/

TCM Style Acupuncture Performed Before and After Embryo Transfer Improves Pregnancy Rates: A Retrospective Study

Acupuncture done before and after embryo transfer increases pregnancy rates up to 57%.
Acupuncture done before and after embryo transfer increases pregnancy rates up to 57%.

Below you will find a research study written by our acupuncturist, Sarah Prater (under her maiden name, Fredrickson) for the journal American Acupuncturist. This was published in the Winter 2014 edition.

By Sarah .J. Fredrickson, MSOM, Dipl OM (NCCAOM), LAc; David B. Youran, Dipl Ac (NCCAOM), LAc; Glen K. Adaniya, PhD; Bradford L. Bopp, MD; Robert M. Colver, MD; Laura M. Reuter, MD

Abstract

Background
Conflicting evidence exists on whether acupuncture is beneficial for patients undergoing in vitro fertilization (IVF) cycles. This retrospective cohort study was undertaken to determine whether a unique protocol of a combined Chinese and Japanese style on-site acupuncture, performed both before and after embryo transfer, affects clinical outcomes.

Design and Setting
Forty-nine patients received a previously untested acupuncture protocol on-site before and after embryo transfer at Midwest Fertility Specialists, Indianapolis, Indiana, in 2007. The acupuncture treatment was performed 45 minutes before and 15 minutes after embryo transfer. The control group consisted of 212 patients who did not receive acupuncture and who underwent IVF cycles in the same time period. All cycles were fresh, non-donor successful embryo transfers. The clinical pregnancy rate (CPR) was defined as the presence of fetal cardiac activity. Data were analyzed using the unpaired t-test and Fisher’s exact test, with significance defined as P < 0.05.

Results and Conclusion

It was found that patients with a positive hCG were slightly higher in the acupuncture group than in the control group (57.1% vs.45.8%, p = 0.16). The acupuncture group also had a higher CPR (55.1% vs. 34.4%, p = 0.01). The miscarriage rate was lower for the acupuncture group compared to the control group (3.6% vs. 22.7%, p= 0.02). These results support the use of acupuncture in conjunction with IVF.

Keywords: TCM, acupuncture, infertility, IVF, embryo transfer
Introduction

Infertility affects roughly 1.5 million women in the United States..1 Many of these women will seek out various fertility treatments, and, of these, in-vitro fertilization is becoming more and more common, with 154,412 IVF “cycles” performed in 2011 versus 112,988 in 2003.2 IVF involves the retrieval and subsequent fertilization of a woman’s eggs,  produced by stimulating the ovaries with medications. The resulting embryos are grown in a laboratory setting and then transferred back into the uterus; this whole process takes approximately two weeks.3 Because of the significant cost, time commitment, and emotional impacts required for each cycle, there is great incentive to improve pregnancy and live birth rates. These rates have improved greatly from 14% of all IVF cycles resulting in a live birth in 1989 to 35% in 2008.4 Despite these profound advances, clinics are still searching for ways to improve this live birth rate.

The use of acupuncture has been regarded as a possible treatment to benefit IVF success rates. It has had obstetric and gynecological usage in China for many centuries. Following the 2002 Paulus study that reported increased pregnancy rates in patients receiving acupuncture before and after embryo transfer,5 many groups examined the impact of varied styles of acupuncture on pregnancy rates before and after embryo transfer. Modern research on this topic has shown mixed results. Some researchers found that groups that had sham or placebo acupuncture had higher pregnancy rates than the true acupuncture groups, although the difference between the two groups was not statistically significant.6,7,8

Complications in varied treatment styles and the effective sham and placebo treatments in acupuncture infertility discussed literature studies are visible in recent searches. This research questions the necessity of using sham or placebo acupuncture when examining the role acupuncture can play in pregnancy rates following IVF. This is due to the objective nature of a pregnancy test and the possibility of an acupuncture-induced stress reduction as the mechanism by which pregnancy rates are increased and thus considered as a therapeutic effect.9 Other research and meta-analysis shows inconclusive results that, during an IVF cycle, acupuncture can improve pregnancy rates. At this time there is not enough evidence to recommend it clinically for all patients.12,13,14

Nevertheless, experts in acupuncture and infertility continue to support more studies on the use of acupuncture before and after embryo transfer to improve pregnancy rates.10 Possible mechanisms of action might be the increased blood flow to the uterus, stimulation of the release of endogenous opioids, and the mediation of neurotransmitter release affecting gonadatropin-releasing hormone and its effect on the menstrual cycle10 or the regulation of cortisol and prolactin during the medication phase of the IVF treatment.11

The purpose of this review of individual cases was to examine the influence of acupuncture before and after embryo transfer on pregnancy rates in patients undergoing IVF. The objective was to determine if acupuncture treatment given before and after embryo transfer (ET) would improve pregnancy rates.

Methods

A retrospective review of charts was done at an Indianapolis fertility clinic on 261 patients who received IVF in 2007. Charts were chosen based on the successful completion of a fresh, non-donor embryo transfer in 2007 with or without acupuncture. No exclusions were made in the acupuncture group, but some statistical outliers within the control group were eliminated to ensure the groups were statistically similar in oocytes per patient, embryo cell count, and embryo fragmentation score. No exclusions were made specifically regarding diagnosis, age, or other factors.

Forty-nine patients received acupuncture by a single board certified licensed acupuncturist on-site before and after embryo transfer. The treatments were given in the same location as the ET to reduce traveling induced stress, which seems to improve results in other studies.12 The 212 patients who did not receive acupuncture served as the control group for this analysis. The charts in both the acupuncture and no acupuncture groups were reviewed retrospectively for beta pregnancy and clinical pregnancy by D.Y and G.A.

Controlled ovarian hyperstimulation was achieved by use of a standard gonadotropin releasing hormone agonist and recombinant follicle stimulating hormone (rFSH) protocol with the dosage varying for each patient. Antral follicle count and E2 levels were not collected for this study. Following human chorionic gonadotropin administration and oocyte retrieval after 36 hours; oocytes were inseminated 2 to 4 hours later by either standard insemination or by intracytoplasmic sperm injection (ICSI). Embryos were scored using standard morphological criteria on the morning of the Day 3 embryo transfer (ET). Embryos were assigned a fragmentation score of 4 if there was no fragmentation, a 3 if less than 10% of the embryo exhibited fragmentation, a 2 if between 10% and 50% of the embryo was fragmented, and a 1 if the embryo had greater than 50% fragmentation.

Acupuncture points were selected according to a combination of traditional Chinese and Japanese acupuncture for the treatment of infertility and through consensus of 4 experts in the field. The points were chosen to harmonize the Kidney and Spleen qi according to Japanese and Chinese theories. Acupuncture treatment was performed 45 minutes before embryo transfer and 15 minutes after embryo transfer. Acupuncture points used before the embryo transfer were Qihai CV-6, Guanyuan CV-4, Sanyinjiao SP-6, Taixi KI-3, Zhongfeng LR-4, Zusanli ST-36 and Yanglingquan GB-34. Acupuncture points used after the embryo transfer were Yinlingquan SP-9, Taichong LR-3, Taixi KI-3, Zusanli ST-36, and Yanglingquan GB-34. All points were needled bilaterally without the elicitation of the de qi sensation and the needle depth varied form 0.25 cun to 0.50 cun.. Needles were retained for 35 minutes. Seirin 0.20 x 30 mm acupuncture needles were used.
The beta pregnancy rate was the percentage of patients who had an initial hCG level, drawn 12 days after the embryo transfer, of 10 mIU/ml or greater. The clinical pregnancy rate (CPR) was defined as the percentage of patients with fetal cardiac activity. The miscarriage rate was the percentage of patients that had a positive hCG level but that failed to develop a fetal heart rate. Data was analyzed using the unpaired t-test and Fisher’s exact test, with significance defined as P < 0.05. The results are expressed as mean standard deviation or percentages as appropriate.

Results

The number of oocytes, cell number, fragmentation score, number of embryos frozen and number of embryos transferred in both groups was equivalent. Positive hCG was slightly higher in the acupuncture group versus the control group (57.1% vs. 45.8%). The clinical pregnancy rate for the patients receiving acupuncture was significantly higher than the control group (55.1% vs. 34.4%). In addition, the loss rate was significantly lower in the acupuncture group (3.6% vs. 22.7%). ( Insert Table 1/ and Graph)

All fresh, non-donor IVF cycles that ended in successful embryo transfer were included in the study. No exclusions were made in the acupuncture group, but some statistical outliers within the control group were eliminated to ensure the groups were statistically similar in oocytes per patient, embryo cell count, and embryo fragmentation score. No exclusions were made specifically regarding diagnosis, age, or other factors.
There were no adverse events related to the acupuncture treatment reported.
Discussion

Although other studies regarding acupuncture and IVF are inconclusive, perhaps the positive results in this study relate to several important factors .12,13,14 Acupuncture attempts to stimulate the body’s own reproductive potential, which may help to explain the positive results of this study. In addition, the treatments were performed on-site, eliminating the stress of traveling to another site before and after the embryo transfer.

Because the patients in this study received acupuncture immediately before and after ET, this could also explain the positive results. Studies showing treatment immediately before and after treatment at the same site had higher pregnancy rates in the acupuncture group compared with studies that did not specify time of acupuncture.12,13 The higher clinical pregnancy rate and lower miscarriage rate in the acupuncture group may be due to increased blood flow to the uterus.10

The unique combination of the Chinese and Japanese styles of the acupuncture treatment protocol in this study suggests there is still more research needed on the best protocols to treat infertility issues with acupuncture. This study was limited by its chart review nature and would benefit from having been a randomized controlled trial. The small number of patients in the acupuncture group as compared to the control group reflects that.

Also, considering that patients themselves elected to join either the acupuncture or control group, it is possible that the acupuncture patients had a healthier lifestyle, or some other confounding factor, which could have impacted results. There was no way to account for these factors during the chart analysis as charts were chosen only based upon the patients’ completion of a fresh, non-donor IVF cycle in 2007. Additionally, there was no way to determine if anyone in the control group received acupuncture from another practitioner on the day of ET, which may have affected the results. Due to these limitations, this analysis suggests there is still more research to be done on how best to treat infertility issues with acupuncture.

Conclusion

The results of this study point to the possibility that acupuncture is safe and may increase both clinical pregnancy rates and beta pregnancy rates in women undergoing IVF ET. In addition, this study showed a decrease in the loss rate among women in the acupuncture group. In comparison with the inconclusive results found in the literature, this study had a few key differences, including acupuncture performed on-site, acupuncture being performed immediately before and after ET, and the usage of a unique Chinese- and Japanese-derived type protocol.

A blinded, randomized study containing a larger number of  patients is necessary to determine if these results are clinically useful. Additionally, more research should be done to identify the key factor (or factors) within the methods of this study that led to the positive results.

References

1. Centers for Disease Control and Prevention [Internet]. Atlanta: CDC; c2013 [cited 2013 June] FastStats. Available from: http://www.cdc.gov/nchs/fastats/fertile.htm

2. Society for Assisted Reproductive Technology [Internet]. Birmingham (AL): SART; c1996-2013 [cited 2013 June] Available from: https://www.sartcorsonline.com/rptCSR_PublicMultYear.aspx?ClinicPKID=0

3. Society for Assisted Reproductive Technology [Internet]. Birmingham (AL): SART; c1996-2013 [cited 2013 June] Available from: http://www.sart.org/detail.aspx?id=1903

4. Society for Assisted Reproductive Technology [Internet]. Birmingham (AL): SART; c1996-2013 [cited 2013 June] Available from: http://www.sart.org/SART_Success_Rates/

http://www.sart.org/SART_Success_Rates/

5. Paulus WE, Zhang M, Strehler E, El-Danasouri I, Sterzik K. Influence of acupuncture on the pregnancy rate in patients who undergo assisted reproduction therapy. Fertility &  Sterility. 2002 Apr; 77(4): 721-4.

6. Moy I, Milad MP, Barnes R, Confino E, Kazer RR, Zhang X. Randomized controlled trial: effects of acupuncture on pregnancy rates in women undergoing in vitro fertilization. Fertility & Sterility. 2011 Feb; 95(2): 583-7.

7. Andersen D, Lossl K, Nyboe Andersen A, Furbringer J, Bach H, Simonsen J, Larsen EC. Acupuncture on the day of embryo transfer: A randomized controlled trial of 635 patients. Reproductive Biomedicine Online. 2010 Sep; 21(3): 366-72.

8. So EW. Ng EH, Wong YY, Lau EY, Yeung WS, Ho PC. A randomized double blind comparison of real and placebo acupuncture in IVF treatment. Human Reproduction. 2009 Feb; 24(2): 341-8.
9. Manheimer E. Selecting a control for in vitro fertilization and acupuncture randomized controlled trials (RCTs): How sham controls may unnecessarily complicate the RCT evidence base. Fertility & Sterility. 2011 Jun 30; 95(8): 2456-61.

10. Stener-Victorin E, Humaidan P. Use of acupuncture in female infertility and a summary of recent acupuncture studies related to embryo transfer. Acupunct Med. 2006 Dec; 24(4):157-63.
11. Magarelli PC, Cridennda DK. Cohen M. Changes in serum cortisol and prolactin associated with acupuncture during controlled ovarian hyperstimulation in women undergoing in vitro fertilization-embryo transfer treatment. Fertility & Sterility. 2009 Dec; 92(6):1870-9.
12. Manheimer E, Zhang G, Udoff L, Haramati A, Langerberg P, Berman BM, Bouter LM. Effects of acupuncture on rates of pregnancy and live birth among women undergoing in vitro fertilization: systemic review and meta-analysis. BMJ. 2008;336:545.

13. El-Toukhy T, Sunkara S, Khairy M, Dyer R, Khalaf Y, Coomarasamy A. A systematic review and meta-analysis of acupuncture in in vitro fertilisation. BJOG: An International Journal of Obstetrics & Gynaecology. 115: 1203–1213. doi: 10.1111/j.1471-0528.2008.01838.x 2008.

14. Cheong Y, Nardo LG, Rutherford T, Ledger W. Acupuncture and herbal medicine in in vitro fertilization: a review of the evidence for clinical practice. Human Fertility. 2010 March; 13(1): 3-12.

Bios

Sarah J. Fredrickson, MSOM, Dipl OM (NCCAOM), LAc, completed a BS in biology at Indiana University in 2005 and completed her Master’s Degree in Acupuncture at Southwest Acupuncture College in Santa Fe, New Mexico, in 2008. She is currently in practice at Indiana Reproductive Acupuncture. Her clinical interests include infertility, prenatal care, and other women’s health issues.

David B. Youran, Dipl AC (NCCAOM), LAc, is the director and founder of Indiana Reproductive Acupuncture. He studied acupuncture and Oriental medicine during a four year apprenticeship program taught by Dr. Thomas Duckworth at the Inochi Institute in St. Louis, Missouri. He is the first acupuncturist in Indiana to specialize solely in treating infertility and pregnancy wellness issues.

Glen Adaniya, PhD, graduated from Northwestern University and earned his MS and PhD in Biomedical Engineering at the University of Illinois in Chicago.

Bradford Bopp, MD, graduated from The Ohio State University, attended medical school at the University of Southern California, completed his residency in obstetrics and gynecology and his fellowship in reproductive endocrinology at Harvard University.

Robert Colver, MD, graduated from Indiana University, obtained his medical degree from the Indiana University School of Medicine, completed his residency in obstetrics and gynecology at St. Vincent Hospital in Indianapolis, and served a fellowship in reproductive endocrinology and infertility at the Medical College of Georgia.

Laura Reuter, MD, graduated from Cornell University, earned her medical degree at the University of Illinois, completed her residency in obstetrics and gynecology at Wayne State University, and completed a fellowship in reproductive endocrinology at the University of Illinois.

Adding Acupuncture to an IUI Cycle: Our Integrative Approach

Acupuncture treatment during an IUI cycle can improve your chances of pregnancy!
Acupuncture treatment during an IUI cycle can improve your chances of pregnancy!

For families navigating the world of assisted reproduction, many will find themselves considering an IUI cycle to get pregnant. IUI, or intrauterine insemination, involves a combination of hormones to stimulate a woman’s ovaries and the insertion of prepared sperm directly into the uterus during ovulation to increase chances of conception.

The rates of success of this treatment vary, but hovers, on average, around 10-20% per cycle for most women. Most couples will do 2-4 IUI cycles before additional treatment or IVF is recommended, though there may be reasons to consider an increase or decrease in the number of cycles attempted based on your specific diagnosis or situation.

If you’re like most facing an IUI cycle, you want to know what you can do to help increase your chances of success. Acupuncture treatment during an IUI cycle can help to optimize your body for conception and increase chances of pregnancy. While most of the fertility-acupuncture research is done on IVF, similar principles will apply. Acupuncture works by improving blood flow to the uterus and ovaries, regulating hormones, and helping reduce stress. All of these things together help to increase your chances of a take-home-baby.

RESEARCH: There are only a few research studies examining IUI and acupuncture specifically. One notable study out of Israel showed that women who did a combination of acupuncture and herbs with their IUI cycle had a pregnancy rate of 65.5% vs 39.4% who did the IUI alone, and live birth rates were 41.1% in the acupuncture group vs 26.9% in the IUI alone group. This is incredible news!

TNCRA PROTOCOL: Our protocols are based off the latest research and timed according to your cycle. You can begin treatment at any point during the cycle, but we like to start treatment 1-3 months prior to the IUI when possible to help improve the quality of the eggs and help bring your body into balance to optimize conditions for conception. We also like to work with men 1-3 months prior to the cycle to help improve sperm quality. We typically do not recommend herbs while you are taking any hormones, as the effects in combination with medications are largely unknown, though they may be used in the months or weeks leading up to the cycle. 

We will see you about three times during the IUI cycle itself. Each treatment, and it’s timing, is detailed below. The timing of the treatments is important, so we will stay in close communication with you during your cycle to make any needed changes.

First Treatment: Around cycle day 5-9

-improve blood flow to uterus and ovaries

-reduce stress

-decrease side effects of medications -increase egg quality and quantity

Second Treatment: Within 24-36 hours of the IUI procedure

-decrease uterine contractions

-facilitate ovulation

-support progesterone levels

-reduce stress

-increase the thickness and quality of the uterine lining

-improve blood flow to the uterus

Third Treatment: 5-7 days after the IUI

-decrease uterine contractions

 -increase implantation rates

 -reduce stress

-support early pregnancy

Once you have a positive pregnancy test, (fingers crossed!) we strongly recommend acupuncture to help support early pregnancy and reduce any symptoms such as fatigue and morning sickness. You can read more about prenatal acupuncture here.

As always, we are available to answer your questions and we will work with you and your cycle to create a plan that works best for you. Please call or email, we look forward to working with you! And good luck!!

What to Expect During Your First Acupuncture Treatment

Never had acupuncture before? Relax! This article will help relieve your fears.

We understand there is a lot mystery surrounding our medicine and the questions or even fears you might have the first time you come into our office. Rest assured, we are here to make you feel safe, comfortable, and help you grow your family!

If is our hope that this will help you feel more at ease at your first appointment, but if you have any specific concerns, please feel free to ask!

Your initial treatment will last about 60-90 minutes: At your initial visit we make sure to have plenty of time to discuss your fertility history, goals, general health, and ensure all of your questions are answered. We’ll go over the benefits of acupuncture, what you can expect, and your treatment plan. You will then receive a full treatment session. It’s a good idea to make sure you’ve had something to eat before your appointment. Sometimes a treatment can make you feel momentarily lightheaded and this is more common if you’re hungry.

The treatment itself is very relaxing: When we are ready to begin treatment, you will be asked to lay down on a massage table either face up or face down. If we need you to undress to reach points on your back, for example, you will be allowed to change and get under a soft, flannel sheet. We keep our tables heated so you will be nice and warm, but we can turn them down or off if you get too warm.

The needles: After you’ve goteen situated on the table, we will swab all the points were going to use with alcohol and begin inserting the needles. Don’t worry, we will tell you when we are about to begin so there are no surprises! The insertion of the needle can feel like a tiny pinch, but many people don’t feel anything at all. Once they are all inserted you shouldn’t feel anything uncomfortable. If you do, tell your practitioner so they can make adjustments for you. Soon you will find yourself in a deep state of relaxation.

Length of Treatment: Once all the needles are in, and you are comfortable, you will be left to rest. The needles are left in for about 20-30 minutes and you will be checked on to ensure you remain comfortable. Most people will find themselves in a state of deep relaxation or even fall asleep!

Diet, Supplements or Herbs: 

We sometimes make dietary or lifestyle recommendations if we feel it will support your goals. Occasionally, we will recommend herbs or supplements to support your fertility, though they are not always appropriate during every cycle or for every patient. The majority of the supplements we recommend come from Theralogix.  They are leaders in fertility supplements and all of their products are third party tested. We also sometimes make dietary recommendations based on your overall diagnosis if we feel it will support your goals. If you would like to order one of their products, feel free to use our PRC discount code: 137923 or give us a call. We carry a few of their most popular fertility supplements here in the office.

Once the treatment is finished, needles will be removed. After you change, we will go over your treatment plan and reschedule you, if needed.

After your treatment you will probably feel very relaxed. You might find that you sleep well that night. If you have any questions after your treatment please call or email the office.

Our IVF Acupuncture Protocol: Improving Pregnancy Rates up to 60%

A painless and relaxing complement to your upcoming cycle that can increase your chances of success!

With the development of in-vitro fertilization, many families unable to conceive were suddenly given hope. Over the years, there has been great scientific interest in improving this procedure and success rates have increased greatly and currently hover right around 30% for women under 35.

While this is all great news, most will agree that a success rate of 30% in the youngest population of infertile women leaves a lot of room for improvement. Women going through or preparing for IVF treatment will wonder if there is anything else they can be doing to improve their chances. In addition to maintaining a healthy body weight and healthy lifestyle, acupuncture remains one of the most commonly sought after complementary treatments for couples going through IVF. With numerous research studies showing improved pregnancy rates, many doctors and fertility clinics are coming on board with combining their treatments with acupuncture.

In our clinic, over the last two years, we saw a pregnancy rate around 60% for all women who went through an IVF cycle. This number includes all ages and all types of transfers (frozen, fresh, and egg/embryo donor). These results are truly amazing and in line with what many other acupuncturists are seeing in their own clinics.

Just think, if all women going through IVF had acupuncture treatment we would have so many more success stories and the cost savings of not having to do repeated IVF cycles would be astounding!

We use a protocol inspired by the work of Dr. Magarelli and Diane Cridennda, and other fertility acupuncture research, that involves a series of treatments specifically timed throughout your IVF cycle to help support each phase of your cycle. This protocol has been shown to not only increase your chances of getting pregnant, but improves live birth rates as well! They found a reduction in the number of miscarriages, rates of ectopic pregnancy, and even lower numbers of multiple pregnancies when using this protocol in combination with IVF. The protocol has even been shown to help keep certain hormones at levels consistent with women who get pregnant on their own to support a healthy, successful cycle. After all, the ultimate goal is a take-home-baby!

We divided the protocol into 4 phases corresponding with your cycle. The bulk of the protocol begins when you begin your cycle medications, but it is recommended to being treatment designed to help prepare your body for your upcoming cycle about three months before your expected cycle. 

 

4 Phases of TNCRA’s IVF Acupuncture Protocol:

  1. Pre-Conception: Treatments in the 3 months preceding the cycle to manage stress, regulate hormones, and help your body prepare for the cycle. For more information about our preconception program click here
  2. Ovarian Stimulation: Treatments are done twice weekly along side your ovarian stimulation medications to help increase the quality and quantity of your eggs and reduce side effects.
  3. Transfer: A treatment given immediately before and/or after your embryo transfer to increase blood flow to the uterine lining, reduce uterine contractions, and manage stress. We are available 7 days a week for pre and post embryo transfer appointments. 
  4. Transfer Follow Up: One treatment 5-7 days post embryo transfer to support implantation, early pregnancy, and reduce stress. 

 

Throughout your treatment you can expect to feel more relaxed, get better sleep, and see a reduced number of medication side effects like bloating, mood swings, and cramping. Many of our patients report that the cycles they’ve done with acupuncture are ‘easeir’ than those done without. And, hopefully, at the end of it all you will get those long-awaited two pink lines!

TNCRA’s owner and acupuncturist, Sarah Prater, inserts needles into a patient.

We are comfortable working alongside any of Knoxville’s fertility doctors and have even seen patients from doctors in neighboring areas and out-of-state. We work closely with your cycle and will check in frequently to make sure the timing of your treatments is the most beneficial for your cycle. We truly love our work and want nothing more than for you to have the family of your dreams.

Please feel free to contact us by email or phone at 865-315-3845 if you have questions about your own cycle or are interested in scheduling an appointment. We also have online scheduling available.

 

Please feel free to reach out, we are always happy to help! 

 

 

 

We wish you the best of luck with your cycle!!

5 Things Your Fertility Acupuncturist Wants You to Know

New to acupuncture? We really don't care if you haven't shaved your legs.
New to acupuncture? We really don’t care if you haven’t shaved your legs.

Since many of our patients have never had acupuncture before, we put together this somewhat playful list of things to know that might help you be a bit more comfortable at your acupuncture appointment. Enjoy!

  1. We don’t care if you’ve shaved your legs (or if you shave them at all): Trust me, the last thing we’re thinking about when we’re looking for a point is how prickly or smooth your legs are. If I had a dime for each apology I’ve received for unshaven legs, I’d be rich! We do palpate to find the location for the needles, and that is the real focus. We’re usually trying to feel for a landmark along a bone or muscle to help us find the correct location for the point.
  1. We don’t notice your imperfections: People come in all shapes and sizes. I know we are all self conscious about certain things (hips, thighs, feet, belly, etc.), and for many women weight can be a big issue. Sometimes, body confidence can take a hit if you experience bloating with fertility treatments, or if you’re pregnant and your body is changing in new and unfamiliar ways. We think you look amazing! We’re here to help you along your journey to motherhood and are not thinking about your size, shape or anything else. However, if your weight might be an issue related to your fertility, we can talk about helping you make changes to get down to a healthy weight. 
  1. We want to know if you’re afraid of needles: While the needles are painless and the treatment is very relaxing, we like to know if there is an underlying fear. There is a lot we can do to help alleviate fears such as answering your questions, explaining any aspect of the treatment in more detail, helping you breathe through needle insertions, or not mentioning needles at all! Our main goal during the treatment is to help you feel comfortable, so speak up! Trust us, after the first needle is put in, that fear will melt away!
  1. Tell us if you are uncomfortable during the treatment: If you’re too hot or too cold, let us know! If a needle feels uncomfortable, let us know! If you’re not sure how you can lay your arm comfortably without bumping a needle, ask and we’ll help you! I’ve even scratched a few itchy noses after needles were put in. (Why do noses always start itching the minute you can’t easily scratch them?) Anyways, in addition to receiving your acupuncture treatment, we want you to relax and enjoy it.
  1. It’s ok to share: We understand that infertility and pregnancy are deeply personal and it may be uncomfortable, hard, or even painful to share some of the details of your story. It is ok if you laugh, cry, or just don’t want to talk about something. We listen with open hearts and always have a tissue ready. We ask to understand your history and to better understand you as a person. We also know things come up during our conversations that are considered “TMI” to many people. There is no such thing as TMI with your acupuncturist, so don’t ever shy away from something you feel is important because of what we might think. More often than not, what you share is incredibly helpful in giving you the best care. We are very used to talking about all things fertility and pregnancy related and want to use that information to help!

Combining East and West: 5 Keys to Successful Fertility Acupuncture

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Benefits of a fertility specialist and other tips for successfully adding acupuncture to your fertility treatment.

Please read the guest blog Sarah wrote for Circle Bloom. Circle Bloom has developed downloadable audio tracks to help foster a healthy mind-body connection while you are on your fertility journey. They have programs for all stages of the journey including fertility treatment, natural conception, pregnancy and beyond. We highly recommend their programs. Check out their free download here.

If you find yourself sitting in the waiting room of the fertility clinic, you’re probably wondering if you’re doing all you can to help your cycle be a success. You might have heard about some women adding acupuncture to their treatment cycles or even considered it yourself.

Acupuncture is a safe and effective way to increase your chances of conception and can be combined with IVF, IUI, and other fertility treatments. Many fertility clinics are even starting to offer acupuncture in-house! If you aren’t so lucky as to have such a clinic nearby, this article is for you!

At our clinic, Tennessee Center for Reproductive Acupuncture, we specialize in combining acupuncture and fertility treatments. We see many benefits to this approach such as:

  • Reduced stress and anxiety
  • Decreased medication side effects
  • Improved egg quality and quantity
  • Increased thickness and quality of the endometrial lining
  • Improved pregnancy and live birth rates
  • Prevention and reduction of uterine contractions
  • Decreased chance of miscarriage and ectopic pregnancy
  • Encouragement of embryo implantation
  • Hormone regulation

Adding acupuncture to your already complicated fertility treatment schedule can seem like a daunting task, but luckily there is help! Read below for a few tips we’ve learned on how to best incorporate the two treatments:

  1. Try to find a fertility specialist in your area. An acupuncturist who specializes in fertility will be familiar with the type of treatment you are undergoing and may have even worked with your doctor. They will usually have flexible scheduling to allow for last minute changes in your treatment and even have extended availability for pre and post embryo transfer appointments.
  2. Call before your treatment starts. While acupuncture can be started at any point during a treatment cycle, many acupuncturists have protocols they use for each type of cycle. So calling a month or so before your cycle begins can allow you to plan for your appointments. At the Tennessee Center for Reproductive Acupuncture, we often recommend treatments in the weeks before your cycle, but most of our protocols begin when the cycle starts.
  3. Keep communication open. Make sure your acupuncturist knows of any changes or problems that come up during your cycle. This can help us better time your appointments and allow us the opportunity to help treat side effects and issues, all to help your cycle become a success.
  4. Continue treatment during pregnancy. Assuming your treatment is a success, (fingers crossed!) acupuncture can be safely used to support a healthy pregnancy for you and your developing baby. We strongly recommend treatment during the first trimester, as this is the time when most miscarriages occur. It can also help alleviate morning sickness, fatigue, stress, and other symptoms. Many women will continue treatment throughout their pregnancies!
  5. Let your acupuncturist know your treatment results: We are very passionate about our trade and feel the highs and lows right along with you. So, please let us know how your cycle turns out! And we always welcome little ones for a visit!

Welcome and a little of our history….

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Welcome to Knoxville’s first and only acupuncture clinic specializing in fertility and prenatal wellness!

Hello and welcome to the Tennessee Center for Reproductive Acupuncture’s first blog post!

I’d like to take a moment and introduce the myself, the clinic, and tell you a bit about the services here.

My name is Sarah Prater. I am the founder and acupuncturist at the Tennessee Center for Reproductive Acupuncture. I recently moved here with my family from Indianapolis, IN. We came to be closer to the mountains and our family. As avid cyclists and outdoor lovers, we feel at home up in the Smokies. And, personally, I LOVE the warmer weather down south!

I studied pre-medicine at Indiana University in Bloomington and finished my bachelor’s in 2005. I went on to complete a master’s degree in Oriental Medicine in 2008 and have maintained a private practice ever since. I decided to become an acupuncturist instead of continuing on to medical school gradually during a time of self reflection. I was suffering from some health issues and had discovered that my diet, lifestyle, activity level, and some alternative treatments had such an impact on how well I felt and how well my medications and other treatments were working. I thought of my future patients and how I wanted to instill this knowledge in them so they could help themselves feel as I did! Over time, and with the guidance of a few mentors, I decided to pursue a career in Chinese Medicine.

In my early years of practice, I began to realize how much I truly loved working with families trying to conceive. Nothing beats a patient bringing their new bundle of joy into the office for a quick visit! I also realized the clinical benefit that acupuncture treatment could have on someone undergoing fertility treatment. Aside from increasing pregnancy rates, acupuncture was helping my patients reduce side effects, stress levels, and making each cycle a little easier to go through. Research in integrative fertility shows acupuncture can decrease miscarriages, ectopic pregnancies, and increase overall live birth rates. Once pregnant, it can help a woman feel more comfortable during her pregnancy and have a faster, easier birth with reduced interventions. It seemed my specialty had found me!

After deciding to specialize in fertility and prenatal wellness, I was able to focus my efforts on meeting the needs of my patients by offering flexible scheduling (as the body cannot be reliably put on a calendar), treatments around embryo transfer and developing protocols that work with a woman’s cycle, whether natural, medicated, IVF or IUI. It also afforded me the time to be able to stay current with research in the field, which is something I truly value.

I am so excited to be bringing my passion here to Knoxville! The Tennessee Center for Reproductive Acupuncture is our area’s first and only fertility and prenatal speciality clinic. We are truly built from the ground up to be able to work alongside your treatment cycle and (hopefully!) pregnancy.

It is my sincere hope that all families experiencing fertility challenges will be able to realize their dream and we are here to help.

In the future, this blog will serve as a voice for our clinic in addition to Facebook and our website. We will post clinic updates, case studies, research, patient guides and tips and anything else that we feel will be of service to you, our patients.

We truly look forward to working with you! Please contact us if you have any questions or would like to set up treatment with your cycle or during your pregnancy. We are happy to answer your questions and find a treatment that is right for you.