Acupuncture and Chinese Medicine help improving the quality of uterus lining, and reduce uterine contractions during embryos implantation. They are considered alternative nature therapy which can complement IVF/IUI procedure.
Uterus lining –
Endometrial thickness is a commonly measured parameter in IUI/IVF procedures. “The appearance, as well as the thickness of the endometrium, will depend on whether the patient is of reproductive age or postmenopausal and, if of reproductive age, at what point in the menstrual cycle they are examined.”-https://radiopaedia.org/articles/endometrial-thickness. “The normal endometrium changes in appearance as well as in thickness throughout the menstrual cycle.”
A menstrual cycle includes three phases: Menstruation phase, proliferative phase and secretory phase.
In the menstruation and early proliferative phase uterus lining is a thin, brightly echogenic stripe comprising of the basal layer.
In the late proliferative phase(prior to ovulation), uterus lining develops a trilaminar appearance: outer echogenic basal layer, middle hypoechoic functional layer, and an inner echogenic stripe at the central interface.
In the secretory phase(or after ovulation), uterus lining is at its thickest and becomes uniformly echogenic, as the functional layer becomes oedematous and isoechoic to the basal layer (figure 2); there is through transmission and posterior acoustic enhancement noted in the ultrasound.
Normal range of endometrial thickness
Commonly accepted endovaginal ultrasound values are as follows: -https://radiopaedia.org
In premenopausal patients, there is significant variation at different stages of the menstrual cycle. Also these measurements are a guide only, as endometrial thickness may be variable from individual to individual.
during menstruation: 2-4 mm
early proliferative phase (day 6-14): 5-7 mm
late proliferative / preovulatory phase: up to 11 mm
secretory phase: 7-16 mm
We have heard for a long time from reproductive specialists that implantation is ALL about the embryo and further …… ALL about the quality of the egg or its aging (in women over 37) chromosomes. This theory suggested that good follicle reserve, good eggs, and embryo that was genetically normal are all they need from you to make magic happen.
But reality is in most IVF clinics only about half of the “genetically normal” embryos (determined by pre-implantation genetic diagnosis/screening, PGD or PGS) actually implant and become a viable pregnancy.
So what is going on with the large number of genetically normal embryos which DON’T implant?
As concluded by acupuncturepregnancy.com.au, there are eight factors that can affect embryo implantation in uterine lining.
- “The lining of the womb must be adequately prepared for pregnancy (decidualised) before it can recognise and accept an embryo. On an ultrasound, a more receptive lining has a tri-laminar appearance. The action of oestrogen in the follicular phase leading up to ovulation, stimulates the lining to develop until it shows this 3 layer appearance. ” or the uterus lining has to develop into certain size. With thin uterine lining, there are formula of herbs to stimulate the growth which we consider it lack of Kidney Jin. There are also research paper published on improvement of uterus lining and embryo implantation on acupuncture and Chinese herbs.
- There must not be any structural impediments to implantation, such as uterine abnormalities, polyps, fibroids, retained products from an earlier miscarriage or adenomyosis. These problems of the uterus and uterine lining can cause or contribute to reproductive problems such as infertility or recurrent miscarriage:
- Uterine Polyps
- Uterine Fibroids (proper medical terminology is myoma or leiomyoma): fibroid size can range from 10 cm to 1 or 2 cm. Fibroid sized 5 cm below is more responsive to acupuncture treatment. Treatment normally needs at lease 2 visits per week and last about 3 months, some may need more time or 6 months treatment. Acupuncture changes the hormone distribution and improve the micro Eco-system for uterus.
- Intrauterine adhesions – scar tissue within the uterine cavity, also called Asherman’s Syndrome. This can interfere with conception, or can increase the risk of a miscarriage.
- Congenital uterine malformations, such as a bicornuate uterus, a T-shaped uterus, or a uterine septum
Chinese Medicine also considers the quality of uterus lining. To deal with fibroid or polyps and adhesion, in addition to acupuncture, there are certain formula of herbs to move the blood and Qi, and also remove dampness.
- Luteal phase defect – an uncommon condition that involves inadequate development of the microscopic and cellular changes in the endometrial lining of the uterus after ovulation and exposure to the hormone progesterone.
- Good blood supply to the deeper layers of the endometrium. There are research papers in support of improving blood flow with acupuncture and Chinese herbs.
- A calm and chilled out uterus
Uterine contractions and implantation
“Frequency of uterine contractions increase around the time of ovulation (maybe to help sperm move up into the tubes), and usually calm down by about the time of implantation (under the influence of progesterone) some 5 – 6 days later. However its not unusual for women having an embryo transfer in an IVF cycle, to experience some cramping, which might not be conducive to implantation. The more contractions after embryo transfer the lower the rate of successful implantation. As you can see from this graph (Hum Reprod, vol.13 no.7 pp.1968) when there are more than 5 contractions per min the implantation rate drops to around 10% compared to lower rates of contractions where the implantation rate is 50%.”
There are papers done by German and Chinese doctors to support acupuncture can reduce uterine contractions and help implantation in IVF cycle.
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