Infertility, insights and options

Approximately a quarter of couples have difficulty conceiving at some point in their lives, leading to approximately 1 in 6 consulting a fertility specialist in hospital. However, the number of couples who are actually infertile is lower, at around 5%, so if you are struggling to conceive it is well worth exploring the issues and options.

Causes of Infertility
People tend to think of infertility as a women's problem, but the reality is that infertility is equally common in men and women accounting for about a third of cases each. In the remaining cases, the cause of infertility cannot be identified. Fertility problems are on the increase; this is largely attributed to increasing exposure to environmental toxins in our lives and because women are starting their families later.

Female fertility problems are more likely to occur in women with irregular or absent periods, with a history of sexually transmitted infections (which may damage the womb or fallopian tubes), with ovarian problems, such as polycystic ovarian syndrome (a condition associated with multiple cysts in the ovaries) and/or endometriosis (where womb tissue grows inappropriately in the fallopian tubes or the womb). Male infertility is most commonly due to abnormal semen, reduced sperm count or reduction in sperm quality.

Factors affecting fertility in both men and women include being overweight, a history of sexually transmitted infections, smoking, exposure to chemicals, pesticides and other environmental factors and stress. Stress can reduce libido (sex drive), affect ovulation and limit sperm production. Alcohol, illegal drugs and certain medicines can also play a role in infertility.

Why age matters?

Men and women are most fertile during their 20s. In women, fertility declines more quickly with age; several factors are involved, particularly reduction in egg quality. Around one third of couples where the women is over 35 have fertility problems, this increases to two thirds where the woman is over 40. The NHS recommends that you consult your GP if you have not conceived within one year of having regular unprotected sex (every 2 - 3 days), and sooner if you have any reason to be concerned about your fertility or if you are a woman over 35 - as fertility testing can be a lengthy process.

Treatment Options

Medical treatment options include prescription drugs and hormones, surgical procedures (to clear fallopian tubes for example) and assisted conception, such as intrauterine insemination (IUI), where the man's best quality sperm are inserted directly into the womb, or in vitro fertilisation (IVF). IVF involves collecting a woman's egg, fertilising the egg with sperm outside the woman's body and then placing the fertilised embryo back in the woman's womb. During the treatment process, the woman receives several drugs and hormones to help maximise the success of the treatment. The overall success rates of IUI and IVF are 15% and 29% respectively, but decline as a woman ages. Some of the medications and medical procedures used to treat infertility can cause unwanted side effects or complications. NHS funded fertility treatment and eligibility varies across the UK so some couples opt for private treatment which can be expensive.
Today an increasing number of couples are using complementary therapies to help with infertility and associated problems.

Acupuncture for Fertility and IVF

Acupuncture has been used in China and the East for thousands of years to treat a wide range of conditions including fertility. The evidence for the success of acupuncture in treating a range of fertility problems is well documented. The World Health Organisation (2003) lists female infertility, male sexual dysfunction, polycystic ovary syndrome among conditions for which the therapeutic effect of acupuncture has been shown.

Acupuncture for fertility has been shown to help increase blood flow to the reproductive organs, balance hormone levels, regulate the menstrual cycle, help improve the lining of the uterus and egg quality and reduce stress. Other conditions such as endometriosis, often associated with infertility, have also been shown to improve with acupuncture.
A study published in the British Medical Journal (2008) reported that acupuncture administered at the time of embryo transfer can improve pregnancy rates by 65% in women receiving in vitro fertilisation (IVF). A 2004 study in the USA found that 51% of women receiving IVF with acupuncture became pregnant compared to 36% of those who had IVF only. The latter group had higher rates of miscarriage and stillbirth (20%) compared to those women who had received acupuncture (8%).

Embarking on a course of IVF treatment is demanding and stressful. In addition to improving the outcome of IVF, acupuncture can also help reduce stress and anxiety, and the side effects of the drugs used in the IVF process.
Acupuncture can also help treat male infertility. In a 2005 study at Shanghai University (China), men receiving acupuncture had a higher percentage of sperm in their semen and their sperm were healthier than those not receiving acupuncture.

As a holistic therapy, acupuncture helps address the underlying health issues which may disrupt the body's natural balance resulting in fertility problems.

Optimising your Chances of Pregnancy

In the absence of a specific physical fertility problem, making simple lifestyle changes to improve your health can help improve your likelihood of getting pregnant. Eat a nutritious, balanced diet with plenty of fruit and vegetables, wholemeal bread and pasta for carbohydrates and lean meat, fish or pulses for proteins. Green leafy vegetables are recommended as they are high in folic acid which helps prevent birth defects. Also be aware of foods to avoid. Aim for a healthy weight with a body mass index (BMI) of 19-25. It is vital to stop smoking, cut out alcohol and illegal drugs.

Most importantly - have plenty of sex! If you have regular periods and we call the first day of your period Day 1, then you are likely to ovulate between Day 10 and Day 16. It's best not to get too stressed about the specific timings, just try to have regular sex during the days when you may be ovulating.

Managing Stress & Anxiety

Fertility problems can be deeply distressing, especially where infertility is long lasting or not resolved. Infertility may result in depression, anxiety, sexual difficulties, relationship problems, marital tension and feelings of guilt, anger, bereavement or loss. In addition, stress levels may be worsened as a result of the side effects of medical fertility interventions or worries about the cost of private fertility treatment. On top of all this, your well meaning friends may be telling you - just relax and it will happen......aaaarrrrgh!

If you are feeling stressed, an important first step is recognising that it is reasonable, indeed it is quite normal, for you to feel some anxiety about your situation. You need to find a stress reduction programme which works for you - we are all different. Regular exercise is proven to reduce stress. If the gym is not for you, then a walk in the forest or a fun salsa class can help relieve tension. There's a wide range of relaxation techniques available, from meditation tapes to breathing exercises and creative visualisation techniques which can help.

Many couples struggling with infertility issues find it helpful talking through their emotions and feelings with a professional counsellor. Regular acupuncture, massage or reflexology can help provide relaxation and reduce tension.
Whatever your situation, be kind to yourself and seek professional advice if you need it.

Judy is a registered Member of the BAC, useing acupuncture and therapeutic massage to treat a wide range of conditions in Crowborough and Tunbridge Wells. 01892 664939 or 07593 341439. www.acupunctureinsussex.co.uk