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Acupuncture, Yoga, Massage: Do Alternative Treatments for Fertility Work?
a blog by Beth and Tami of Pulling Down the Moon
Recently we were contacted by a reporter to comment on a study out of Denmark (the “Denmark Study”) that basically says “use of complementary and alternative medicine (CAM) is associated with a 30% lower ongoing pregnancy/live birth rate during 12 months of fertility treatment." The reporter was a regular CAM columnist and she said she felt the study was somewhat negative and was curious about research out there that says the opposite, that CAM services actually help enhance conception rates.
We have always felt it imperative to look at holistic therapies through the eyes of a scientist. After all, we’re partnered with the two largest fertility clinics in the country (Fertility Centers of Illinois and Shady Grove Fertility), and know that in order for patients to benefit from these types of therapies, the medical community has to believe in their efficacy, on some level, too.
We discussed the Denmark Study with a doctor partners just the other day to get an opinion on the matter. The response was something we hear from many of our doctor partners, “If we could just keep people in treatment for longer periods of time, success rates would be higher.”
So why is it difficult to keep people in treatment? Beyond the financial burden, research published by Fertility and Sterility in 2004 says that the number one reason women drop out of three insurance paid IVF cycles is due to stress.
It seems unarguable that CAM services such as yoga, breathing, meditation, exercise, reiki, reflexology, acupuncture, massage (the list goes on) or even prayer can help alleviate anxiety and tension and reduce cortisol, the primary stress hormone in the body. The American Society for Reproductive Medicine (ASRM) has said that there isn’t conclusive evidence that stress causes infertility; however, infertility can cause stress.
Stress, as we all know can lead to chronic disease and other fertility threatening conditions such as obesity, depression, change of sleep habits and a compromised immune system.
As with all research, a critical eye should be used when looking at results. Consider the following points with regard to the Denmark Study:
• All CAM therapies were grouped together. The authors of the study say, “A main limitation was that we could not ascertain which type of CAM was most associated with lower pregnancy rates.” For example, other research in the field suggests that acupuncture done before and after embryo transfer can significantly increase conception rates and may improve blood flow to the uterus. In addition, body weight can negatively impact fertility. Research shows that lifestyle modifications such as diet and exercise (both CAM therapies) resulted in higher pregnancy rates than with medical treatment using clomiphene and metformin in patients with PCOS. These lifestyle modifications also improved lipid profiles and reduced waist circumference, both indicators of lower risk for chronic disease in years to come.
• Who delivered CAM services in the study? The importance of using qualified, licensed practitioners who are experts in the area of fertility intervention cannot be overlooked.
• Is there inherent selection bias in the study? Perhaps the women who answered the questionnaire were poor responders in the first place which is why they turned to CAM therapies. Further to consider is that some women may have gotten pregnant using CAM therapies and, therefore, did not show up at their doctors’ office for medical treatment thus excluding these women from the questionnaire used in the study.
• The Study says that CAM services should be monitored. This is the very nature of why CAM is an outdated term. We use the term “Integrative Care for Fertility.” It does not imply that you choose either the medical route or the holistic route. You choose both and integrate them seamlessly into your treatment. Your medical doctor knows exactly what you are doing holistically and your practitioner knows exactly what you are doing medically. That, we believe, is the future of healthcare in our society.
Whether you believe in the study, CAM, medical intervention, natural fertility or something not even listed here, we believe it’s important to debate and investigate all sides of an issue in order to help patients make the best choices possible.
In light of the heated town hall debates going on in our country regarding health care reform, we hope that the media will continue to engage in an unbiased dialogue regarding the role of CAM in American healthcare. Not to get too political about this, but we are in a healthcare crisis. Many patients do not have access to medical fertility coverage. What about these folks? Many of the wonderful, high-tech fertility options like IVF, PGD, IUI, and hormonal treatments come with a high price tag. Isn’t it common sense that we should be educating our population of patients on the efficacy of lifestyle interventions that control stress, weight gain, and other conditions potentially detrimental to fertility? This is why working together with the medical community in educating patients about all kinds of options becomes a cost saving and wellness enhancing proposition.
If you are as passionate as we are regarding this issue, let us know. Comment here, on our Facebook or web pages or email us. Perhaps together we can make sure that patients have the best information possible when making choices about their fertility treatments.
Beth Heller and Tami Quinn
Co-Directors/Co-Founders, Pulling Down the Moon, Integrative Care for Fertility