Acupuncture for fertility: An interview

A friend referred me to Jackie O'Neill of Collaborative Care in Chicago about two years into our fertility journey. By that time, I'd experienced a miscarriage at 8 weeks, two failed IUIs, and two failed IVFs. I was feeling hopeless and needed a different approach. 

Jacqueline O'Neill, MSTOM, L.Ac

Enter Jackie and Traditional Chinese Medicine (TCM). Committing to acupuncture, herbs, and the lifestyle changes she recommended is one of the best decisions of my life; not only is she an expert in her field, she was the first professional I encountered who offered hope and optimism that I could get pregnant. She encouraged me to find similarly minded professionals to round out my care. I'm so glad I did.

Because acupuncture is such a key part of my story - really, the turning point - I want to share its benefits and answer some questions I had and continue to hear from clients with you. Below is an interview with Jackie. I hope it is helpful and I encourage you to ask questions in the comments. If you are considering acupuncture as part of your care, please contact her for a consultation.

What are the benefits of acupuncture for fertility?

The benefits are many. Acupuncture helps regulate cortisol, a stress hormone. You may often hear the statement “stress does not cause infertility”. Yes, while stress does not cause infertility, it absolutely can exacerbate infertility. Acupuncture, and any other mind body modality or activity for that matter, helps manage the negative effects cortisol has on fertility. 

Acupuncture also stimulates angiogenesis. What does this mean? Acupuncture can literally create more vasculature and therefore blood flow to the ovaries. Also, acupuncture can calm the sympathetic nervous system, allowing a shift to a relaxed, parasympathetic state. This shift facilitates circulation to smaller network vessels that aren’t essential to keep us alive. We don’t need our ovaries to live, but we do need healthy ovarian function to have healthy pregnancies!

What do you want people to know about acupuncture and trying to conceive?

I want people to know they have options and Chinese medicine is absolutely one of them. There are cases where acupuncture and Chinese medicine will be more effective than conventional fertility treatment, cases where the two disciplines should be integrated, and cases where conventional fertility treatment is going to be more effective and incorporating acupuncture can increase the chances for success. Some cases benefit from a short term approach, ie. receiving acupuncture during the ovarian stimulation phase of an IVF cycle. Other cases - diminishing ovarian reserve for example - might require a longer course of Chinese medical treatment to support egg quality while trying to conceive naturally, or in preparation of a future IVF cycle. In all scenarios, acupuncture will benefit fertility in some way!

If someone feels they can't afford acupuncture, what options do they have?

Many places offer community acupuncture, which is typically a shorter session in a group setting. Some clinics might also work on a sliding scale with eligible individuals. Insurance companies are also increasingly covering acupuncture.

What are some TCM tips you can share for those in the midst of an ivf or iui cycle now?

Generally speaking, much can with diet during an active ART schedule. Diet is extremely important; in my opinion, a good fertility diet potentiates the effects of acupuncture. Oocytes are cells. Cells age faster if we eat a poor diet, burn the candle at both ends and chronic insomnia. Proper nutrition and healthier sleep habits can help slow the signs of aging eggs in the ovaries just like every other cell in the body. 

From a Chinese medical perspective, a diet that supports and unburdens the “Liver” during an ART cycle is most helpful and something that women can control. The high dosages of fertility medications are intended to increase estrogen levels quite quickly. While this is important for the IVF cycle and is indicative of patient response, or follicular maturation, the temporary hyper-estrogenic stagnates Liver function. Therefore a diet that detoxifies - or in TCM parlance, courses and drains Liver qi - is very good to incorporate. Foods that have bitter and/or aromatic flavors generally will course Liver qi. Examples are green leafy veggies (chards, kale, spinach, arugula) and herbs like basil, cilantro and oregano. 

What should someone look for when choosing an acupuncturist?

Like any therapy, I think it's important to find a practitioner you feel comfortable with. Scheduling phone consults or reading patient testimonials/reviews can be helpful. You can see if your fertility acupuncturist is a member of reproductive medical societies, or groups. To become a fellow of ABORM (American Board of Oriental Reproductive Medicine) for example, the acupuncturist must pass a board examination and meet the requirements of ABORM's approved reproductive medicine continuing education courses.

How do you respond to common fears around acupuncture - fear of needles, for example?

Fertility patient tend to have less fears because chances are they have had to do plenty of blood draws and injections before coming to me. If someone has anxiety around needles, I treat at their pace and make sure they are comfortable while they are on my table. 

what compelled you to choose acupuncture, and then with a specific focus on fertility, as your career?

I always wanted to work in healthcare. My father is a 3rd generation pharmacist and I was heading down that path when I realized holistic healthcare resonated more with me. I then decided to pursue a degree in Chinese medicine. 

I knew I wanted to focus on fertility while I was in Chinese medical school and I had the wonderful opportunity to intern with a fertility acupuncturist for 2 years during that time. A couple years into my private practice, my husband and I started trying to conceive to no avail for too long. I already felt a strong desire to help people build their families holistically, however my own personal struggle helps me understand even more what women and couples are going through and has shaped the practitioner I am today. 

in your experience, is there an ideal "mix" or "formula" for those trying to conceive?

The formula starts with an accurate understanding of both partners' reproductive medical history, or lack thereof, which requires further testing before I administer treatment. Only then can treatment be most accurate in my opinion. Once the diagnostic tests and procedures are done, IVF with PGS might be what's needed. Regardless, I believe acupuncture, diet and herbal supplementation is often a great prep "formula" that makes IVF and FET cycles finally work!

Do you have a favorite success story you can share?

This is a tough one, there are so many! My favorite success stories involve women who have gotten pregnant naturally after being told they have a less than 1% chance of getting pregnant because of poor egg quality; often it was recommended that these women use a donor egg. While donor eggs do significantly increase healthy pregnancy rates in this population of women, and allow women and couples to build a family quicker, some individuals just aren't ready to take that step just yet. Helping these women achieve something they never thought was possible is definitely one of the most rewarding and joyous parts of my job.

My favorite integrative medicine success story involves a a dual factor infertility case. She came back to my practice for her second child and mentioned she had already attempted a round of IVF the month earlier and did not respond favorably. She was a full-time working mother with a toddler, so understandably, it was challenging to find the time, use the finances and put extra energy to her own self care for weekly acupuncture sessions again. When I asked how her diet and lifestyle was, she answered like every other full-time working parent would; "You know, I often go all day without meals, eat a lot of snack food and eat my toddler's leftover mac and cheese for dinner." I remember this all too well. It's a survival, getting through the day state but NOT a fertility friendly one to say the least. 

I asked her the toughest question. Can she could hold off for 3 months before attempting another round so we could help support her fertility with acupuncture, nutrition and herbal supplements? As all fertility patients know, waiting is so very hard. She had just experienced a poor response to IVF, so I think it made more sense to her to wait, but it was still hard nonetheless. She waited; she received treatment; she rocked her diet as best she could! She then got pregnant with a Day-5 blastocyst transfer while all of her previous IVF attempts resulted in day 3 transfers. And, she was 3 years older...