The Heart of ART
When using acupuncture alongside Assisted Reproductive Technology (ART), accurate diagnosis and appropriate treatment are always of utmost importance but, for me, the technology, and how acupuncture can help, is only one part of the story.
As part of my work as an acupuncturist, I worked for 7 years in a fertility and gynaecology clinic. I spent a lot of time with nurses, consultants and embryologists. I watched egg collections and embryo transfers, observed semen analysis and stared into fridges and down microscopes at new life starting out. As with many aspects of the modern world, I found myself amazed. This technology is fascinating and the benefit of acupuncture alongside it seems clear to me, even if the research within the scientific community is not yet conclusive.
In this article I’d like to focus on a slightly different point. It has been my experience that the biomedical model and its language often overwhelms people, and this can make it difficult for them to connect with their physical, mental and emotional experience in a way that empowers them in the process. Often patients seem to feel helpless and this is why they turn to us for help. As a result of my experience, I now believe that the conversations we have with ART patients may be just as important as where we place the needles.
Relaxing can be stressful
There is no doubt in my mind that stress plays a huge role in the difficulties some people face when trying to conceive. Most of us are familiar with the scenario of the couple struggling to have a baby, either naturally or with ART, who give up trying and then conceive with relative ease. We might understand this as a reduction in the impact of stress hormones on the reproductive system or the influence of the mind on the ‘Uterus‘, 'ZiGong' (子宮), which in Chinese medicine includes the ovaries and fallopian tubes via ‘Bao Mai’ .
Either way, as most people having ART are already invested in biomedical language, I almost always start by explaining one aspect of the biomechanics by which acupuncture supports the reproductive system (by promoting the parasympathetic limb of the autonomic nervous system). Some patients want all the biomedical science but I’ve found that scientific language doesn’t fit well with most people’s everyday experience. Some patients respond better to being told that acupuncture will calm their mind and relax their body, and often just want acupuncture to help them relax, unconcerned with other potential benefits. So, depending on the patient, I choose my language carefully to fit with what they need from me.
Two things I am certain of are that the minute people enter fertility clinics and start having tests, their stress levels rise; and that telling people to ‘just relax’ or to ‘try not to worry about it’ only makes them feel more desperate.
So my advice starts with suggesting they accept some stress and anxiety as part of the process. Patients often want to eradicate all stress and anxiety, as they instinctively know, and have often been told, the problems these can cause. This in itself is stressful and, in my experience, is also unrealistic; as there is always stress and anxiety around the things we care about. Trying to suppress them is actually more likely to heighten the sensation. So, I encourage discussions around how they can reduce other stresses in their lives and suggest they try to accept everything else as part of the process. I point out that acupuncture increases endorphins and that this will help to reduce the impact of the stresses they can’t avoid. I regularly notice people breath more deeply from this point.
Nourishing ourselves is not always easy
I also encourage conversations around nourishment and what this means to them. In my mind, everything we do is an attempt to nourish ourselves in some way. Acknowledging this is a helpful step towards a healthy existence and, as an acupuncturist, a key part of my process in starting to help people understand the choices they make for themselves. Chinese medicine teaches us that it is the relationships between things and not the things themselves that define them, and this is especially important during the fertility journey. Our relationships are sources of nourishment and this includes our relationships with ourselves. For me an important word is kindness. I am surprised at how often there is a sense of failure for women about the difficulty they are having conceiving, as if they haven’t revised hard enough, or didn’t listen properly in class. So we discuss the way they nourish themselves physically, mentally and emotionally, and I listen carefully to what they say and how they talk, and steer them towards a kinder attitude towards themselves and the things they do.
Food is a source of mental and emotional as well as physiological nourishment. As a result, I’m not a fan of being too strict around diet.. My goal is to help people find ways to eat foods that nourish them in all these ways. The importance of eating natural, wholesome food feels clear to me, but it isn’t for everyone and we can’t all do this all of the time. So, I am careful not to increase the patient’s stress and anxiety around this topic. I encourage people to understand their system and to know themselves well enough that they can make good choices. I often think that small changes are enough and if I can help them to understand the energetics of different foods and how they relate to the energetic balance of their system, then I feel I can help them make even better choices.
Another important source of nourishment, in my experience, comes through our social connections. We are social beings and don’t do well in isolation, but the fertility journey is often private and, as a result, many patients gradually isolate themselves. I don’t encourage patients to discuss their situation openly but I do encourage conversations about how they are going to maintain the personal connections that nourish them along the way.
This issue has presented itself in some interesting ways over the years and one particular scenario seems commonplace: the good friend’s wedding. I suppose it's that stage of life and, like an old friend, it pops up from time to time. Patients worry about whether they can have a drink or not, whether people will notice if they don’t, and how the day will be as a result. I think this scenario encapsulates so many of the issues couples face when undergoing fertility treatment.
My thoughts about it have changed over time and, as with all patients, I don’t have a one-size-fits-all approach, but it’s my opinion that, for many, spending the day avoiding the champagne tray and, as a result, reminding themselves of their difficulty may not be helpful. If it were an issue for them, in some cases my advice would be to have a glass, raise it high and celebrate the love of their good friends. Savour every mouthful and enjoy the feeling it gives. My point here is that maybe sometimes nourishment is about a good meal and going to bed early, and sometimes it’s about having fun with friends and celebrating life.
Moreover, it may be that conception isn’t just an accident of biological mechanisms but is rather an expression of the creative potential within nature. So, during treatment, I talk to patients about the value of continuing to do the things that they find nourishing, calming and uplifting: a walk in the countryside; a trip to the cinema or gallery; lunch with friends.
What's the point?
In my mind, accurate diagnosis and treatment are key. Excesses and deficiencies of Blood and Qi, the relative balance of the 5 elements, or any of the modalities of Chinese medicine diagnosis, all give us a good structure to understand a person’s fertility. Chinese medicine is a valuable tool with the ability to empower people to make good choices and the conversations we have with patients can help them understand how they can do this. In doing so, they can help the ‘Uterus’ flourish via the ‘Heart/ Bao Mai’ connection, and help allow the creative potential within themselves to manifest.
Rick's article was originally published in British Acupuncture Council magazine 'Acu. Spring 2018' edition.
Article featured image courtesy of Martin White of Whirligig Creative Ltd: www.whirligigcreative.com