Fertile ground for therapy
Date:
Jul 22 2007
Source:
Times Colonist, Vancouver Sun, Province and Nanaimo Times newspapers How acupuncture and TCM can help support infertility
by Katherine Dedyna
Complementary medicine is providing an alternative for women trying to get pregnant
Leanne Proniuk's belly couldn't be any bigger. She's due to give birth tomorrow, and says she would not be headed for the delivery room without the help of complementary medicine.
She first got worried about her fertility when she had been off the birth control pill for 15 months but was still experiencing cycles as long as 84 days.
In a step recommended by local fertility expert Dr. Stephen Hudson, she drank many a "disgusting concoction" of 10 to 15 Chinese herbs such as dang gui to normalize her menstrual cycles. She also underwent several months of acupuncture treatments at Elements of Health costing $70 apiece.
The 31-year-old childcare consultant was initially skeptical, but open enough to try it. Last fall she became pregnant.
"Part of me thinks it's hocus-pocus, but it also worked. I'm a believer now and I've recommended it to other people."
Across town, it's "legs up against the wall, girls," at the Yoga for Fertility dropin class.
As the sun streams into the heritage studio of Viva Diva Fitness, three women silently listen to Martina Bell's instructions:
"Think about letting go of any tension."
"Think about your desire."
"See it in your mind and feel it in your body."
Many affirmations later, she intones: "It's not your job to worry how you'll get pregnant; it's the belief that you will.''
Bell says that yoga is a way to reduce stress, tension and maintain "energetic flow" particularly in the hips, pelvis and reproductive organs.
With infertility problems now affecting one in eight Canadian couples, would-be mothers (and fathers) are turning to complementary medicine and practices to optimize their chances of success -- or at least convince themselves they've tried everything.
And the increase has been significant, notes Judith Daniluk, a UBC professor of counselling psychology and author of The Infertility Survival Guide. She cites a recent Australian study that found nearly half of 97 patients surveyed had consulted with a chiropractor, acupuncturist, naturopath or other complementary care provider and up to a third used herbal remedies.
Complementary methods won't unblock fallopian tubes, but if yoga calms and grounds women struggling with infertility, it's positive, says Beverly Hanck, executive director of the Infertility Awareness Association of Canada.
"I have every reason (including some very sound studies) to believe that alternative therapies can genuinely help some infertile couples," she asserts.
The Society of Obstetricians and Gynecologists of Canada can't offer an opinion on the burgeoning issue. "It's not a subject that we've looked into," a spokesman says.
The B.C. Medical Association's spokesman on alternative medicine expects more research to emerge, given how hurtful infertility is. But at this point, Dr. Lloyd Oppel says he has no "good reason" to think that acupuncture, for instance, can increase the chances of fertility.
Hudson, the obstetrician in charge of the Victoria Fertility Centre, disagrees. He performs acupuncture on all his in-vitro fertilization patients. "There is no doubt in my mind that it helps people but it doesn't help everybody."
His interest in Chinese medicine predates the clinic's opening in 2003.
"Chinese medicine, yoga -- anything which combines the mind and the body-- I think is really important," he adds.
His first hope is trying to help couples conceive naturally and "complementary measures can be very helpful in that regard."
As far as IVF and acupuncture, there have been of four controlled studies demonstrating "a robust positive impact," wrote Dr. Alice Domar, an assistant professor of obstetrics at Harvard University. "But it is impossible to be certain that the placebo effect was not a factor."
Does that really matter, she asks. "There is minimal evidence to support the use of clomiphene citrate with infertile patients, yet it is routinely the first line of treatment," she writes in a 2007 paper.
Earlier this month, the European Society of Human Reproduction and Embryology issued a news release noting that in a study of 818 Danish women, those who used complementary therapies, among them reflexology and nutritional supplements, during year-long IVF treatments actually had a 20 per cent lower pregnancy rate.
Whether complementary therapies diminish the effectiveness of medical interventions or that persistent treatment failure encourages women to seek alternatives is not clear, says Cardiff University's Jacky Boivin.
When Proniuk first got worried about her fertility, her physician referred her to a gynecologist and in turn she was referred to Hudson, who told her she had multifollicular ovaries. She ovulated several eggs but none made it far enough for fertilization. He suggested traditional Chinese medicine.
The View Royal resident was amazed to find her cycle reduced to 36 days after one month of treatment and to be pregnant after three.
So how can needles stuck in the body correct fertility issues?
Practitioner Stephanie Curran explains that TCM is based on meridians in the body that are connected with internal organs. By stimulating external parts with needles, she can affect internal organs.
She has taken a dozen courses in infertility from New York to Vancouver and five in pregnancy-related acupuncture and has worked with Hudson for several years.
"Acupuncture can help optimize fertility by increasing the blood flow to the reproductive organs, so this is going to help build and nourish a rich uterine lining and also support successful implantation," says Curran, who sees up to 50 patients a week, the majority for fertility issues.
Curran says that acupuncture also helps to reduce stress. "And it has been shown that stress can have an effect on the hormonal balance of the body and may interfere with different reproductive functions like ovulation."
Eva, a 36-year-old teacher, is taking the fertility yoga class and is also getting acupuncture in the hopes of counteracting a two-fold fertility issue: She's in early menopause and her husband has a low sperm count due to a vasectomy reversal.
The couple is trying artificial insemination at Hudson's clinic. She's hoping the needles applied between her eyes, on her hands and wrists, lower legs, feet and belly will help send blood to her uterus.
"I feel I'm doing everything I have to do to put all the chances on my side," says Eva. "Women who get pregnant just like that -- they don't know what we're going through."
There's no doubt that women worried about their fertility are stressed.
"Once that period comes, it crushes you down," says Susan, 27, who asked that her real name not be used. She finds Bell's yoga class "really relaxing" -- a nice antidote to the "what's wrong with me?" feeling she gets every time relatives ask her when she's having a baby.
As the class continues, the women lie flat on their backs, reaching their arms over their heads. Sometimes they rock their hips side to side. They do the cat and cow position, with spine up, elbows on the ground. Now they're in the diamond position, their knees open.
"You feel awesome. Let go of the failure feeling," urges Bell, who also works with Hudson's office. Her graceful manner also gets a workout in her day job as executive receptionist to the premier.
There are no downward dogs or lotus positions or Sanskrit terms in this class. "This is not a traditional yoga class," says Bell. It's based on the work of Czech physiotherapist Ludmilla Mojzisova.
The class appreciates the plain talk, the affirmations and the hope Bell offers.
"When you're desperate you try anything." says Susan.
Daniluk says "the jury is still out on the relationship between stress and pregnancy rates." But she warns: "Patients would be well advised not to assume that they are contributing to their fertility problems because they are stressed. Coping with infertility is difficult enough without that added burden of responsibility."
