Proving a point

from Rowan Pelling
The Guardian, Tuesday 19 February 2008

There is growing evidence that acupuncture can greatly increase a woman’s chance of becoming pregnant. Rowan Pelling is not surprised – she has first-hand experience of the link between fertility and needles.

Acupuncture treatment for Caesarean section I was last in the queue for the BCG jab at school and am not the sort of person who generally embraces needles. So it’s with considerable surprise that I have had to admit that acupuncture works for me. Over the four years I have received treatment, I have discovered its efficacy in all manner of areas, none more so than in boosting fertility.

Fertility treatment is big business in the UK, where it’s estimated that one in six couples experience problems conceiving, so it’s not surprising that scientists are sceptical of a growing fringe industry of “miracle” remedies.

However, a growing body of evidence suggests that the ancient Chinese practice of acupuncture really can enhance a woman’s chance of conception. Two weeks ago Eric Manheimer from the University of Maryland published an authoritative review of acupuncture’s effect on IVF treatment in the British Medical Journal. The report was based on seven studies published in English since 2002 (involving women variously treated with real acupuncture, sham acupuncture or no acupuncture) and found that genuine acupuncture could increase a woman’s chance of pregnancy by 65%.

I first became aware of the link between fertility and needles when a friend sent me to her acupuncturist, Gerad Kite, at a particularly low ebb in my life. I had just had my first pregnancy terminated after the foetus was diagnosed with a terminal condition and I had also learned that my mother had only months to live. Ostensibly I was being treated for paralysing grief, but after the first treatment, when I felt currents of energy move across my body, something very strange happened. I not only felt as if a portcullis somewhere inside had lifted, but I ovulated for a second time that month, just as my regular period was due, and I fell pregnant with my first son as a result.

It was only after these events that I learned Kite had a considerable reputation in the field of fertility treatment (although he is also highly regarded for his work with insomnia, depression and immune system disorders). After my son was born I started to cautiously recommend his clinic to friends. I say “cautiously” because the subject of what doctors now call “unexplained infertility syndrome” is delicate terrain. No treatment, from whatever side of the medical fence, guarantees a happy outcome and most involve a fair bit of expenditure. IVF has an average 15% success rate. If you don’t have any children already, the NHS will provide up to three cycles of IVF for suitable couples, but there can be long waiting lists and one private IVF cycle costs around £2,500. Also, many people view acupuncture as some wacky alternative therapy.

There are two schools of acupuncture and, confusingly, the older-sounding Traditional Chinese Medicine (or TCM) developed out of the Maoist Cultural Revolution. TCM tends to focus on identifying symptoms and treats them via set acupuncture points. The needles are left in the patient for a period of time and treatment often involves the prescription of herbal remedies – although some doctors worry that such herbs can interfere with conventional medicine, including IVF drugs.

The Kite Clinic is one of the foremost exponents of the more ancient school of Five Element Acupuncture. This operates on a more holistic basis than TCM and doesn’t generally involve the prescription of herbs or any extras. If you need to test your sperm or hormone levels, Kite will send you to your GP and patients will be sensitively quizzed on their emotional and mental state, diet and exercise, and full medical background. Following diagnosis (which focuses on uncovering root causes of disorders), practitioners aim to restore patients to their most harmonious state of health. The acupuncturist will use needles to manipulate energy round the body. They are inserted just beneath the skin in a swift in-and-out manoeuvre that provokes a strange, dull, spreading ache or something akin to tiny electric shocks. The underlying principle is that the body’s major organs use energy pathways to communicate and that malaise occurs whenever communication breaks down.

I tell Kite that doctors hate this type of language. “I know,” he sighs, “but research increasingly demonstrates that the mind can have the most profound influence on the body’s health.” The trials in the BMJ report were carried out by TCM acupuncturists, but Five Element practitioners believe it has an even more dramatic effect upon fertility.

However, it is harder to run tests as Five Element acupuncture doesn’t use set points, and treats every patient differently, according to their own individual diagnosis.

When it comes to acupuncture in conjunction with IVF, Kite says that ideally women (and men wanting to improve their sperm health) should start seeing a practitioner at least three months before the treatment begins.

Marie Wren, a consultant at London’s Lister hospital, and the controversial but highly successful IVF specialist Dr Mohamed Taranissi of the Assisted Reproduction and Gynaecology Centre, both refer patients to Kite. Dr Adrian Williams, an NHS consultant at St Thomas’ Hospital, London, agrees that the Five Element approach to “the whole person can only be beneficial to assisted conception”. One friend of mine, a clinical psychologist who lost her first child at birth due to hospital malpractice, says she does not believe she would have been able to cope with the grief and subsequent stress of IVF without Kite’s support. She is now the proud mother of twins.

According to Kite, the inability to conceive sometimes springs from something so simple that it has been overlooked. He cites busy, urban couples who simply don’t have enough sex and stressed, dehydrated women whose bodies mimic menopausal symptoms. Most cases of infertility, however, pose bigger challenges, including polycystic ovary syndrome (POS), endometriosis, repeat miscarriages and men with poor sperm counts or quality.

Kite believes many patients would benefit from trying acupuncture before embarking on IVF. He treated one infertile woman for a BBC documentary on assisted fertility, but she fell pregnant after just three sessions and without the need for IVF.

Many practitioners don’t like acupuncture success stories to appear too miraculous. In my experience, though, acupuncture anecdotes are frequently startling. I am acquainted with the case histories of 10 women aged 36-43 who sought acupuncture to help with conception. Only one had IVF in tandem with it. One had had a string of unexplained miscarriages. Another had been trying to conceive a second child for eight years without success. Two had lost babies at birth and their grief was, unsurprisingly, counterproductive to conception. The rest, myself included, had been trying for a while and felt that nature needed a boost. Eight of us fell pregnant, including the miscarrying woman and the eight-year-gapper (who did so in weeks) the bereaved mothers and the IVF patient. My second son is due on March 9. One gave up after five sessions and the last is still four months into treatment. Kite says 72% of women who have visited his clinic over the past 18 months to boost fertility (whether in combination with IVF or without) have become pregnant and carried a baby beyond the first trimester. The majority are 37 or older.

Cynics cite the placebo effect, but Kite queries why this is viewed as a negative thing: “If you pop a pill from a doctor you like and respect, it will be far more effective than taking medication from one you mistrust. Quality of care is vital when it comes to fertility.”

The Kite Clinic has just received a grant from the King’s Fund (an independent charitable foundation working to improve healthcare) to finance a study in conjunction with Exeter University into the effect of acupuncture on people with MUPS (medically unexplained physical symptoms) including unexplained infertility. Kite hopes the results will help persuade sceptics of acupuncture’s measurable efficacy. But in conversations with his patients, I sense most don’t require a scientific reason why acupuncture aids fertility – as long as it does.