Thankfully, acupuncture can help improve the outcome of assisted reproductive techniques. First, Chinese medicine can help alleviate the side-effects of medical treatments, improving the response to hormonal stimulation. Secondly, acupuncture can help improve the blood flow to the uterus and ovaries, which has been found to be a great determinant in the success of assisted reproductive techniques. Finally, natural techniques can be employed to help alleviate some of the tension which is inherent in these extremely stressful procedures. It has been well documented that stress negatively effects the outcome of ART. A recent study published by the American Society of Reproductive Medicine's Fertility and Sterility Journal, reported that stress impairs the success rate in IVF cycles up to 93%!

One aspect which needs to be stressed, however, is that you need to be hormonally healthy before you go into the cycle. Your best response to any assisted reproductive technique will depend upon your overall endocrine status the few months preceding the procedure. Getting pregnant isn't the goal. Giving birth is. Miscarriage rates are much higher for pregnancies that result from hormonal stimulation. You have within your means methods by which you can improve the quality of response, rather than the number of eggs produced per cycle. Women with fallopian tube obstruction statistically have much higher odds of giving birth than those with "unexplained infertility" or ovulatory disorders, which account for 25 - 40% of those who seek reproductive assistance. That is because they don't have hormonal imbalances which affect the quality of their embryos. As well, conceptions which result from fathers with sperm issues (low count, morphology or motility), have higher rates of miscarriage. You must do everything within your means to ensure you are as hormonally healthy as possible before you attempt medical reproductive assistance!

Techniques to Improve Assisted Reproductive Procedures

Everybody who has been through a cycle of hormonal stimulation knows how difficult this process can be. Numerous visits to the clinic, daily injections, suffering through the side effects, hoping for a good response to the medication, anticipating a smooth insemination, praying implantation is successful, and the dreaded waiting for a positive or negative blood test... the stress is beyond explanation. Most every aspect is out of your control. Measures can be taken, however, to empower you in this process and help you feel like you are truly in charge.

You are in control of your response. This does not have to be the stressful process it seems. The first step in gaining control is to remain calm. Keep the stress hormones out of the equation entirely.

• Do not smoke, use nicotine patches or chew nicotine gum.
• Do not drink any alcohol.
• Do not drink any coffee.
• Eat well, according to your pattern discrimination dietary guidelines.
• Exercise daily before an IVF transfer, but do not perform jarring, high impact or heavy weight lifting exercises which make you grunt and raise the internal abdominal pressure gradient. Rest after transfer.
• Do not strain with a bowel movement; if you are prone to constipation, increase dietary fiber or take a mild stool softener (not a cathartic/laxative.)

Although most clinics do not have you limit your activities after an IVF procedure, assisted reproductive techniques are artificial. Putting an embryo, which has been developing in an artificial laboratory environment, into the uterus changes its environment. The environment in which the embryo will hopefully find its home for the next nine months, needs to be free of stress, tension and the resulting toxic response. Pregnancies that occur as a result of hormonal stimulation are statistically more likely to end in miscarriage. It is especially important to remain as healthy as possible when you are the recipient of these techniques.

Patients who receive the unfortunate diagnosis of "poor responder", meaning they fail to respond to the hormonal medication used during their IVF protocol, are usually pooled into the category of women whose only hope is to undergo donor egg IVF transfers. Some more progressive reproductive endocrinologists have found means to enhance the response to hormonal medication. Improving uterine and ovarian blood flow is one method that dramatically improves response. A study in Human Reproduction, vol. 14 no. 7, 1999, reported that supplementing with 16 g. daily or oral L-arginine supplementation from day 1 of the menstrual cycle until the dominant follicle reached over 17 mm. in diameter improved the response. The study concluded that, "oral L-arginine supplementation in poor responder patients may improve ovarian response, endometrial receptivity and pregnancy rate." Another study in the European journal of Human Reproduction, vol. 15 no. 10, 2000, reported that supplementing "poor responder" patients with 80 mg./day of oral dehydroepiandrosterone (DHEA) for two months prior to stimulation increased the insulin-like growth factor effect about 150% (like growth hormone supplementation does), augmented the gonadotrophin effect and improved response to ovarian stimulation.

Before and during hormonal stimulation, perform the exercises which directly increase blood flow to the pelvic organs:

• Femoral Massage - This exercise increases the blood flow to the pelvic organs, providing more nourishment to the uterus and ovaries. Compress (or have your partner compress) the large artery just beneath the crease in your groin between your thigh and lower abdomen. This is the femoral artery, which comes from the iliac artery. The iliac artery gives off branches which supply blood flow to the uterus, fallopian tubes and ovary. (The ovary has an additional blood supply which branches off the same arterial section that supplies the kidneys.) When the flow has ceased and you feel the pulsation end at your finger tips, hold for 30-45 seconds. The blood is now backing up and increasing the pressure gradient in the iliac arteries and forcing more blood into the pelvic arteries, flooding the pelvic organs with more blood. As more blood feeds the ovaries, more hormonal stimulation will reach them, improving their response. When the hold is released, you should feel a sensation of warmth rushing down your leg as the blood supply returns to the lower extremity. Perform the femoral massage three times, twice daily up until transfer only.

  NOTE: Do not perform this exercise anymore after transfer. If you have high blood pressure, heart disease or circulatory problems including aneurisms, varicose veins, phlebitis, thrombosis, or a history of strokes or detached retinas, do not practice these techniques. If you have diabetes or similar disorder which affects the circulation, but can perform normal exercises and daily routines, practice on one side at a time and repeat on the opposite side. Perform the femoral massage three times on each side, twice daily if possible.

• Qi Gong Breathing - This exercise utilizes the basic life force - the breath, for relaxation, and enhances the body's focus on the reproductive organs. We literally breathe life into and through the uterus.

  1. Breathe in very deeply, and concentrate on bringing your breath from your nose and down the midline of your body, between the breasts, down the abdomen, and eventually focusing your breath down to the region two inches below your navel. This is called the Dan Tien. Let the breath energy pool here.

  2. At the end of inhalation, bring the focus from the area below your navel down through the uterus and to the perineal muscles. Now perform a kegel exercise, squeezing the perineal muscles as if you were attempting to stop the flow or urine. When you release the kegel, begin exhalation.

  3. During exhalation, turn the focus of your attention from the tip of the coccyx and up the spine to the top of the head, then down the midline of the head and out the nose. Repeat steps 1, 2, and 3, until they become one smooth, continuous movement.

• Foot Soak - This relaxing treatment improves the circulation to the lower half of the body, and warms the feet. All the meridians of the body that pass through the uterus go down to the feet. Soaking the feet in warm water for 10-20 minutes per day dilates these blood vessels, and increases the blood flow to the pelvic organs as well; not to mention the relaxing effect of a warm foot soak.
• After transfer, stay in bed for a few days. Do not resume normal activities. Consider that most culture mediums in which an embryo is developing is of a different viscosity than the uterine fluid. When the embryo(s) are placed into the uterus, they will find their way out if the home is not receptive. Remain as calm and stationary as possible. Meditate. Breathe deeply. Listen to soothing music. Order out.
• Meditation with Visualization
  You may do as much of this exercise as you are ready. Read through all of it first, then practice each section, adding to it each time you perform the meditation until the meditation is complete. You may leave the meditation whenever it doesn't feel comfortable, or join it again at any part of the visualization.
  
  Lay down, on your back, with your eyes closed. Relax and breathe deeply. Notice any areas of tension you feel in your body from your head to your neck, down your arms and hands, through your torso, down your abdomen, buttocks, thighs, calves and feet. Tense the tight areas in your body even more, one by one. Breathe in, inhaling deeply down into your lower abdomen. Push your stomach out as you breathe in. Focus your attention on the tension in your body, then tighten the muscles in the area even more, and relax them fully as your exhale. Exhale all the way, deflating your abdomen when you breathe out. Breathe the tension in your body out through the breath.
  
  Focus your attention on the tension, the breath, and the relaxation. Nothing more. When the tension in that particular part of your body is gone, move on to the next part. When you feel relaxed throughout your body, and your mind is clear, begin the visualization. Continue the deep breathing exercise, breathing deep into your abdomen and relaxing with each exhalation.
  
  A river will be used as a metaphor for your life. A garden will represent the endocrinology lab if you are doing in-vitro fertilization. Modify these scenes for your own individual maximum comfort.
  
  Picture your ideal river scene. Picture the banks of the shore, the background scene, the weather, and the water itself. Are the waters rough or calm? Continue to picture this river scene until the flow of the river feels comfortable and safe.
  
  You are on a raft. Picture what you are wearing - is it white and flowing; is it primitive and beaded? It must feel comforting - this will be your maternal gown. Picture the raft as rustic or as luxurious as you wish. This is your raft, your vessel for this journey. Is it hard or soft? Is it made of pure and untreated materials? You may furnish it with pillows, comforters, or keep it bare and natural. Can you feel the waters of the river through the raft?
  
  Let the raft float down the river. Relax and let the waters of life take you down the river. Trust your raft. Trust the water.
  
  When you are ready, let your raft float down to a cove where the water takes you. Picture the cove with fertile banks. The soil on the banks are dark and rich. They receive water from the river of life. They receive ample sun and adequate shade. The banks of this cove will be your special garden. What else will nourish your garden? Who would you like to be there with you? Who is not allowed? You may wall off your garden, or keep it open to the surroundings. Your garden is safe.
  
  Your seed will begin life here. You may remain on your raft, or come onto the banks to assist the process while your seed is receiving the gift of life. Watch where your seed is growing. Help picture the perfect soil. Nourish the soil. Water the soil. Make or remove shade as life begins. You control the environment here.
  
  When your seedling is ready and can no longer receive adequate nourishment from the banks of the shore, you must carefully transplant it. It is now yours. Cradle it, nurture it, breathe into it, talk to it, sing to it. Love it.
  
  Bring your seedling onto the raft with you. Make both of you comfortable and safe. When you are ready, carefully launch your raft back into the waters of the cove. Return to the waters of life with your seedling. It now receives all its nourishment from you. On the rest of the journey it will become one with you. You now move on down the river, together. As one.

  Prayer
  In a number of studies, prayer has been found to dramatically effect medical procedures, including the outcome of IVF procedures, even if the women did not know they were the focus of the prayers. Whether or not you even believe in God seems to make no difference. Prayer seems to open up another dimension of healing, which we cannot explain by our sensory perception.

More On Assisting Reproductive Technique >

• Hormonal Medication Seen Through Chinese Medicine 2
• Personal Stories 3

© Copyright 2000, Eastern Harmony Medical Acupuncture Clinic - All Rights Reserved.  Reprinted here by permission of the author and Eastern Harmony Medical Acupuncture Clinic.