2018 – A busy year of Fertility research and study

2018 has been a very busy year for me and it’s been a while since I wrote a blog article. So I thought I’d use a few spare minutes to let you know what I’ve been up to and give you an idea of what’s in store for 2019.

Over the course of the year, I have been doing the Diploma in Advanced Fertility Acupuncture with Naava Carman, founder of the Fertility Support Company. I’ve attended 5 intensive weekends on various fertility and pregnancy related topics including:

  • causes of infertility such as PCOS and endometriosis
  • reproductive immunology and recurrent miscarriage
  • supporting IVF, IUI and other Assisted Reproductive Techniques
  • treating complex diseases in pregnancy.

It was a wonderful course taught by an inspiring and very experienced, knowledgeable woman. The course included talks from experts in the field such as Dr Thum, specialist in Reproductive
Immunology at the Lister Clinic.  It has greatly enhanced my knowledge of complex fertility issues and given me some valuable contacts. The course culminated in a 5,000 piece of coursework which
focused on anonymously auditing my patient notes to identify women with indicators of reproductive immunological issues and evaluate commonalities and effectiveness of treatment approaches.  It was a lovely piece of work to audit how many women have come to see me and gone on to become pregnant and have babies. I’ll be writing more on this and the other topics in the coming months.

I was delighted to receive my certification this morning from the Fertility Support Company and am proud to display the logo on my website to demonstrate the depth of additional CPD I have undertaken in this field. You can see it on the Welcome page and the Fertility Support page of my website.

In addition to that I have completed another major piece of work that was two years in the making with the lion’s share of the work from September 2017 to September 2018. It was a piece of research in fulfillment of an MSc in Acupuncture with the Northern College of Acupuncture. The research study was about treating Recurrent Miscarriage and utilised the Delphi method which is used to seek consensus between a group of experts. The aim was to produce a set of guidelines and to do so, I assembled a group of fertility acupuncturists with significant experience of working with women who had experienced two or more miscarriages. I asked them what in their view were the most important things to consider when diagnosing, treating and supporting women with this condition. I will write more on this in the New Year as there are a lot of interesting points I’d like to share.

My research has fitted very nicely with the Diploma in Advanced Fertility Acupuncture as there were many commonalities in diagnosis and treatment strategies between the topics covered in the diploma and issues that arose in the guidelines produced by my research. Although my CPD (Continuing Professional Development) in 2018 has focused largely on Fertility Support based topics, much of the subject matter has relevance and is transferable to other health conditions I regularly treat in my acupuncture clinics.

For example, a pervasive theme that crops up throughout working with fertility patients and most other patients is that of “self-care”.  This is a topic that I can identify with particularly after this very busy year. Self-care is a very broad term and means different things for different people depending on their circumstances and the state of their health. It is also something that can be adapted to suit your lifestyle. This will the be the subject of another blog article I am preparing for the new year, where I will reflect further on my experiences of juggling my own acupuncture business, studying and family life and will provide you with tips to look after yourself in your own busy life. However, I wanted to give you just a quick few points on self-care to help you over the festive season…

  • Find a little quiet time for yourself each day where you get to do just what you want guilt-free and without judgment;
  • Get enough sleep – aim for 8-9 hours a night;
  • Aim to get a bit of fresh air everyday, even in inclement weather – just remember to wrap up well;
  • Eat seasonally, naturally and healthily – that means eating warm food cooked from scratch with real foods that include lots of vegetables;
  • Drink plenty fluids (and I’m not talking about alcohol!) – you may prefer warmer drinks in this cold weather;
  • Enjoy time with friends and family, but keep the drinking moderate and have a drink of water for every glass of alcohol you have.

You can read more on ways to keep yourself healthy in the winter and supporting your immune system in earlier blogs I have written:

Although 2018 has been a very busy year, I have thoroughly enjoyed it and am proud of my achievements. I’m looking forward to what 2019 will bring – which will include a few new developments for my clinics… Have a very happy, healthy festive season filled with warmth, laughter and love.

Acupuncturist, Jill Storstein is member of the British Acupuncture Council and  working at Albany Street Clinic, 36a Albany Street, Edinburgh EH1 3QH and Offizone, Kenmore Street, Aberfeldy PH15 2BL. To make an appointment go to the Contacts page or call: 07772 501810

Prenatal health and nutrition

Chinese medicine has long emphasised the importance of a good balanced diet for optimal health. This is particularly important when trying to conceive as we are all made up of “prenatal-Jing” from each of our parents. “Prenatal-Jing” is a broad concept in Chinese medicine that encompasses the inherited DNA from the egg and sperm; and the nourishment a developing foetus receives in utero. It provides us with the foundation for our own health and longevity. The quality and strength of this “pre-natal Jing” is determined by the health of our parents and grandparents.

So, it’s interesting that modern scientific researchers are now finding evidence that this ancient Chinese knowledge can be scientifically proven. It has been recommended for a while now, that pregnant women and those hoping to conceive should take a folic acid supplement. This is because folic acid mimics the naturally occurring substance folate which is essential for the developing spine and helps to guard against conditions such a spina bifida. Research into epigenetics (the switching on and off of genes) is showing that how our cells read the DNA is affected by diet and other environmental factors. A recent report shows that scientists have now been able to demonstrate this also happens in utero and is dependant on the nutrition of the mother in the early stages of pregnancy. This reveals that prenatally, lifestyle and nutrition has a profound effect on the future health and long-term susceptibility to disease of our off-spring and that it is not just folate we need to ensure we are getting.

Professor Andrew Prentice, quoted in the Guardian said, “If a mother’s diet is poor then it causes a whole lot of damage to the genome which has a shotgun effect, so a baby might have possible adverse outcomes. This general phenomenon might explain preterm births, problems in pregnancy, brain defects, or why some babies are born too small.” You can read more on this research in the original article from the Guardian here. This article and the report discussed above focus, on the mother’s health, but a baby is not just made up of its mother. The father’s health impacts significantly on the health of his sperm. There is an ever growing field of research on the role of sperm in recurrent miscarriage and the health of the child.

Ultimately, what conventional and ancient Chinese wisdom points towards and is being increasingly backed-up by research, is that the quality of nutrition developing sperm and eggs, and foetuses receive in utero, plays a crucial role in the health of the child. To get this essential nutrition, it important to eat a healthy balanced diet with lots of nutrient dense vegetables and good quality protein. However, given our intensive farming practices and busy lifestyles, it is not always possible to get enough nutrients from food so adding in good quality supplements can help. You also need to ensure that you have good gut health so that nutrients can be digested and absorbed; and ensure you have good blood flow and circulation to your reproductive organs so the nutrients can get to the womb lining, eggs and sperm.

Acupuncture can help to improve blood flow to and reduce inflammation in the reproductive organs, and help to improve digestive function. Acupuncturists do more than just apply acupuncture – a significant part

of what we do is also to provide appropriate, individualised lifestyle and dietary advice to help you and your future children stay in the best of health.

 

Jill Storstein, MBAcC is a traditional acupuncturist working in Edinburgh and Aberfeldy with a special interest in fertility, pregnancy and paediatric support.

 

 

 

National Fertility Awareness Week 27 October – 2 November 2014

National fertility week
National fertility awareness week

Today marks the start of National Fertility Awareness Week. 1 in 6 couples have difficulty conceiving. Sometimes some simple changes to diet and lifestyle or even a clearer understanding of our reproductive systems can help. However, for others, some form of assistance might be needed.

Acupuncture has grown a solid reputation for supporting fertility for both men and women. So much so that many mainstream fertility clinics recommend and offer acupuncture to support fertility. This article considers what optimal fertile health looks like through the Chinese medicine lens and how divergences from this can give helpful clues to an acupuncturist to help formulate a diagnosis and prepare a treatment plan and inform dietary tips or lifestyle modifications that can help to improve fertility.

Traditional Acupuncture is a branch of Chinese medicine, which is an excellent model to use to understand fertility. Chinese medicine is based on very simple principles that can be combined and interwoven to understand the very complex reality of an individual’s fertility and broader health.

The Yin and Yang of the Menstrual cycle

One of these sets of principles is the ebb and flow of Yin and Yang. This elegantly mirrors the different stages of the menstrual cycle. Yin is still and quiet, nurturing and moistening – it is the preparation phase. Yang is more dynamic and warming, it is the active growing phase.

Yin and Yang
Daoist Yin and Yang symbol

The Yin phase equates to the oestrogen dominated half of the cycle prior to ovulation. It is the first half of the cycle, and is preparing for ovulation by first shedding the endometrial layer from the previous cycle (the period), building the new layer for an embryo to implant into and ripening the follicles. It is responsible for governing the cervical secretions which need to be rich in potassium to fuel the sperm and loose and slippery for the sperm to swim through easily. The middle of the cycle is dedicated to ovulation when the follicle ruptures and the egg is released. The next phase is the Yang phase, the progesterone dominated half of the cycle. It dries up mucosal secretions to allow smooth passage the fertilized zygote and aid implantation. It facilitates the release of nutrients from the endometrial layer to nourish the embryo. If there is no conception and implantation, Yang is the motive force that builds to get the next period started to begin the new cycle.

Observing the Menstrual Cycle

A very useful fertility to tool to view the health of the menstrual cycle is charting. It can help a couple to know when the most fertile time is, and provide useful information for the acupuncture practitioner to track not only the length of the menstrual cycle, but also the length of the Yin/oestrogen phase and the Yang/progesterone phase. Charting is done based on your Basal Body Temperature (taking on waking at the same time each morning) and recorded on a chart. Below is a typical temperature chart.

Sample BBT chart

It shows that in the first half of a typical cycle the temperature is lower than the second half. It shows that there is a dip in body temperature, a result of an oestrogen surge just in advance of ovulation. Around this time you should also see an increase in cervical mucous. Shortly after ovulation at the start of the Yang phase, there should be a spike in temperature, which should stay relatively constant for the remaining half of the cycle.

Charting is not for everyone, it does take dedication to taking the temperature every morning and paying very close attention to the cycle. However, there are other signs and symptoms that can be very informative – details that may not be considered as particularly relevant by a Western medical doctor – but can provide insightful clues into why a couple may be having difficulty conceiving.

Examples of signs and symptoms of particular relevance are: when and how your period starts and finishes; colour of blood; pain at any time during your cycle; headaches; cervical secretions; sleeplessness; mood. These signs and symptoms and temperature fluctuations help to understand the how the balance of Yin and Yang is in the individual and therefore where the focus of treatment should be.

For example, the first half of the cycle is very susceptible to emotional strain and can cause early ovulation (i.e. before day 14). Emotional strain can cause imbalances resulting in a slightly raised temperature, irritability and a degree of insomnia. Early ovulation can mean that eggs are being released before they are fully ripe and therefore either might not be fertilized or may not implant well if they are fertilized. Acupuncture treatment in this instance would focus on regulating your temperature, calming the mind and reducing stress.

Another example can be where the temperature is too low in the second half of the cycle and this can cause poor implantation or early miscarriage. In this instance treatment would focus on raising temperatures and nourishing the endometrial layer.

Each individual woman’s cycle is different and as such each treatment is personalized for whatever your particular set of circumstances might be. Advice around observing the fluctuations in the menstrual will help to maximize chances of conception and can be provided around diet and lifestyle for each individual’s health.

Male Factor

Acupuncture is not just used to support female fertility but male as well. There are a variety of signs and symptoms that can help to identify areas of treatment to focus on for men too. For example, men who experience feelings of coldness, fatigue and reduced sexual desire may well have sperm with low motility. In this case, treatment would focus on supporting the Yang aspect of a man’s health and advice around eating habits may be appropriate.

Research

There has been research into how acupuncture can help support fertility naturally. Showing that it can:

  • be effective in regulating the hormones involved in fertility (Jin 2009, Huang 2009).
  • It can reduce the stress response, also known as “the fight or flight response” which can have a significant impact on the function of the reproductive organs and can inhibit ovulation (Magarelli 2008, Anderson 2007 ).
  • Increase blood flow to reproductive organs – improving the supplying of oxygen and nutrients to developing eggs in the ovaries and improve the blood supply to the uterus, thus making a healthier, thicker endometrial layer – which improves chances of successful implantation. (Stener-Victorin 2006, Lim 2010, Liu 2008)
  • It can work to counteract the effects of PCOS – balancing hormone levels, increasing ovulation and warming the uterus to improve blastocyst implantation (Stener-Victorin 2000, 2008, 2009, Zhang 2009.

Research into acupuncture for male fertility has shown that acupuncture can help to improve sperm maturation (Crimmel 2001), lower scrotal temperature (Siterman 2009), improving blood supply to the reproductive organs (Komori 2009).

More details on this research and full references can be found on the British Acupuncture Council website at the following links:

Female Fertility: http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/female-fertility.html

Male infertility: http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/male-infertility.html