This page provides some introductory information on the most common forms of Assisted Reproductive Techniques (ART). While medical technology has developed rapidly over the years, none of the techniques set out below are easy to go through for those wishing to become parents. For both men and women the procedures can be physically and emotionally draining. The Fertility Support Company’s practitioners have many years of experience providing treatments to support men and women going through all forms of ART.
In-vitro Fertilisation (IVF)
IVF is a method of assisted reproduction that involves combining an egg with sperm in a laboratory dish. If the egg is successfully fertilised and begins cell division, the resulting embryo is transferred into the woman's uterus where it will hopefully implant in the uterine lining and further develop. IVF may be performed in conjunction with medications that stimulate the ovaries to produce multiple eggs (rather than just one as in a normal cycle) in order to increase the chances of successful fertilisation and implantation. IVF bypasses the fallopian tubes and is often the treatment of choice for women who have badly damaged or absent tubes.
The eggs are collected through the vagina using ultrasound for guidance. The operation is carried out as a day-case procedure under sedation or general anaesthetic. You may experience some discomfort following this procedure, but this can be relieved with painkillers. You will also be given antibiotics to prevent infection.
Once the eggs have been collected, they are examined and mixed with the prepared semen before being placed in a special medium. They are then incubated for 24 hours to allow fertilisation to occur. The developing embryos (zygotes) are then left for 24 to 48 hours to allow further growth to occur.
The embryos (up to a maximum of three) are transferred to the uterus 48 to 72 hours after the egg collection, although they can be left longer if they are progressing well and are allowed to get to “morula” or “blastocyst” stage. These more developed embryos are more likely to implant, but there is also a risk that leaving them out of the body longer can arrest in development thereby leaving no embryos to be placed into the mother.
Hormonal treatment to help maintain the pregnancy is given for two weeks following the transfer to the uterus. This hormonal treatment involves either three injections of hCG or daily treatment with progesterone pessaries inserted into the vagina.
In some cases it may be the case that a woman’s eggs are of insufficient quality or are not present due to disease, surgery or immature growth. Similarly a man’s sperm may not be of sufficient quality to create a healthy baby. In these cases doctors will normally recommend consideration of either eggs or sperm from a donor to be used in the IVF process.
Intra-Uterine Insemination - IUI
IUI is the process whereby a sperm taken from the father is injected directly into the uterine cavity in order to bypass the cervix and place the sperm closer to the egg. The sperm are usually washed first in order to remove chemicals that can irritate the uterine lining and to increase sperm motility and concentration.
Before insemination the woman’s ovaries are stimulated with a hormone treatment. This may be given as tablets which are taken between the second and sixth days after the start of the menstrual period, or as a daily injection. The development of the follicles on the ovaries in which eggs are produced are monitored using ultrasound. If this stimulation leads to the development of three or more follicles of a similar size, the treatment will be abandoned for that month to avoid the possibility of a multiple pregnancy. The ultrasound scan is also used to measure the thickness of the lining of the uterus to ensure that it is ready for implantation of the embryo.
Blood tests are used to measure hormone levels in order to determine when ovulation is occurring, although is some case ovulation may be triggered by an injection of a hormone called human chorionic gonadotrophin (hCG). Ovulation will occur 36 to 48 hours after the hormone has been administered and the sperm preparation will be injected directly into the uterus.
Supporting ART with Traditional Chinese Medicine
While Traditional Chinese Medicine (TCM) has developed over thousands of years The Fertility Support Company believes that it is no less relevant when using Western medical technology to achieve a pregnancy. Naava Carman has worked with some of the UK’s leading IVF surgeons to support their patients with acupuncture and herbal medicine and has written and held lectures for others acupuncturists on this topic.
Traditional Chinese Medicine acupuncture treatments for patients undergoing IVF and IUI aim to support the body’s ability to heal while undergoing the significant trauma of hormone therapy and surgery used in ART. Naava would normally recommend a treatment programme over three months prior to undergoing IVF or IUI treatments and then specific acupuncture treatments after the egg collection procedure (in the case of IVF) and the day of insemination. These three months are also useful for patients who have undergone previous unsuccessful IVF cycles. With the information about endometrial lining and follicle growth from previous cycles Naava can better tailor the Traditional Chinese Medicine treatments she offers.
Patients undergoing ART will have regular blood tests and ultrasounds done by the fertility clinic carrying out the procedure, these tests track the progress of their treatments but will also be used by Naava to tailor a patient’s treatment to focus on any specific issue that are arising. For example, if the endometrium is judged to be too thin or there is not enough follicle growth Naava will use specific acupuncture points to address this problem from a Traditional Chinese Medicine perspective. Naava can also offer treatments to support patients suffering from complications arising from ART such as Ovarian Hyper-Stimulation Syndrome(OHSS).
In order to support a fertilisation, implantation and a healthy pregnancy from a Traditional Chinese Medicine perspective, Naava will offer three specific treatments during an ART cycle:
- After the egg collection procedure, Naava will provide an acupuncture treatment designed in Traditional Chinese Medicine terms to help the body heal after the surgery. The aims to encourage the body to focus all of its Qi (energy) on healing the body so that, after insemination the body’s Qi can be focused on supporting implantation in the womb.
- After the insemination procedure (on the same day whenever possible) Naava will provide an acupuncture treatment focused on calming the mind and circulating the Qi around the uterus and fallopian tubes to provide the optimum environment for implantation.
- Naava offers an optional acupuncture treatment during the implantation window (around two to five days after insemination) to give a final boost to the Qi of the body to support the implantation of the embryo.
Over the years Naava has found these treatments, especially when accompanied by a three month preparation programme, to be effective in Traditional Chinese Medical terms in supporting women going through ART.
While there is no scientific consensus on the efficacy of acupuncture in supporting ART, a number of studies have suggested that acupuncture can improve the success rates of IVF. A recent German study (which included a randomised control group) showed improvement in IVF outcome linked to acupuncture. For example, when two sessions of acupuncture were added on the day of embryo transfer the likelihood of a pregnancy outcome was improved from 26% to 42%. However, there are other studies which have not been able to establish a link between acupuncture and successful IVF treatments.
Traditional Chinese Medicine is a complementary therapy and the Fertility Support Company does not advocate it as an alternative to Western medicine. If you are in any doubt about your health or symptoms you are experiencing you should consult your doctor. The Fertility Support Company and its practitioners do not claim to “cure” infertility or any other ailment and do not claim that there is a proven link between their treatments and successful outcomes from ART procedures.
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