MIND-BODY MEDICINE (MBM) THERAPIES FOR INFERTILITY


Some people believe that the mind can have a profound effect on the body. MΒΜ refers to the connection between mental health and body's health. It is a form of alternative medicine. However, MBM is commonly used alongside conventional treatments. In fact, most mind-body practitioners see ΜΒΜ as a way to lower stress, improve quality of life, and cure a disease or illness.
We know that stress can cause a variety of ailments, both physical and emotional. We also know that chronic illnesses, like infertility, lead to tremendous stress, which then may lead to depression, anxiety, and other mental illnesses. MBM offers you a way to cope better with the stress of infertility and fertility treatments. While much more research needs to be done, some research studies have reported improved pregnancy rates for couples involved in mind-body programs. Even in the studies where pregnancy rates were not looked at, the participant's emotional well-being was improved.
According to a study conducted by researchers from the University of California - San Francisco and published in the journal “Fertility and Sterility”, 29% of 428 couples (who were undergoing conventional fertility interventions at 8 reproductive clinics in Northern California) used at least one alternative fertility treatment:
- 22%: Acupuncture.
- 17 %: Medicinal herbs.
- 1 %: Meditation.
- 5 %: forms of body work therapy (such as massage or chiropractic)
Couples who failed to achieve pregnancy with conventional fertility treatments were almost 150% more likely to use alternative therapies than those who succeeded. The older a prospective mother was, the higher a couple's chance of using complementary treatments. Even after researchers adjusted for potential confounding factors such as the number of prior children, use of alternative therapies increased 29% with every five years of the mother's age. The researchers also found that couples with positive views on alternative therapies were 85% more likely to use them than couples with more negative views. Wealth was also a major predictor of a couple's use of alternative therapies; couples with a combined income of more than $200,000 per year were almost three times more likely to use such therapies than couples with a combined yearly income below $100,000.

Stress and Infertility

Twenty years ago the rate of unexplained infertility was between 10% and 20%. Today, for up to 40% of couples, no discernable reason for infertility can be found. And it is in this group that the effects of stress may be most profound. When stress-reduction techniques are employed, something happens in some women that allows them to get pregnant. Stress may actually play a role in up to 30% of all infertility problems. "It is becoming more and more important to focus our efforts on the physiological effects of stress and how they may play a role in conception" says M. Pisarska, co-director of Center for Reproductive Medicine at Cedars Sinai Medical Center in Los Angeles. While the exact pathways between fertility and stress remain unknown, hormones like cortisol or epinephrine (which rise and often remain high during times of chronic stress) may play a key role. It is also possible that reducing stress may help enhance proteins within the uterine lining that are involved in implantation. Moreover, stress reduction may increase blood flow to the uterus, which also affects conception.
While doctors may not know the exact links between stress and fertility, a series of studies shows the impact is hard to ignore. In research published in the journal “Human Reproduction”, pregnancy rates were compared in couples that reported being stressed and those who were not. Pregnancy was much more likely to occur during months when couples reported feeling happy and relaxed. Moreover, doctors say often the stress of undergoing infertility treatments can be so great it can stop even the most successful procedures from working. Thus, it is not just natural (unassisted) pregnancies that are affected. In research published in the journal “Fertility and Sterility” in 2005, experts at the University of California at San Diego reported that stress may play a role in the success of infertility treatments, including in vitro fertilization (IVF). On the other hand, a recent study from the Eunice Kennedy Shriver National Institute of Child Health and Human Development found different effects of stress in conception. The study involved approximately 270 couples, who had just begun trying to conceive, between the ages of 18 and 40. Researchers analyzed their salvia during the fertile window, looking for biological markers of stress. Higher levels of the enzyme alpha-amylase, a marker for stress, correlated with a decrease in the couple's pregnancy rate during the first cycle of the study. But, when researchers looked at all the months from the study combined, there was no statistically significant difference. In other words, this stress enzyme did not lead to trouble getting pregnant. Also, the study found that higher levels of cortisol seemed to be linked to higher rates of pregnancy overall.

Acupuncture

Acupuncture is a form of alternative energy medicine. It is also a mind-body therapy because it induces deep relaxation and emotional release. According to traditional Chinese medicine, it is often combined with herbs to treat:

1. Elevated follicle stimulating hormone (FSH).
2. Repeated pregnancy loss.
3. Idiopathic infertility.
4. Luteal phase defect.
5. Hyperprolactinemia (when not caused by a prolactinoma).
6. Polycystic ovarian syndrome (PCOS) with annovulatory cycles.
7. Hypothyroidism or hyperthyroidism.
8. Spasmed tubes.
9. Male factor including men affected with sperm-DNA-fragmentation.
Patients are commonly treated for three to four months before an insemination, IVF, or donor-egg transfer. Typically most miscarriages occur within the first three months of pregnancy. Therefore, treatment of patients may often last through week 12 to help prevent miscarriage. There are minimal risks when using acupuncture for fertility treatment. A risk of miscarriage may develop if incorrect acupuncture points are used. There are 6 contraindicated points which should be avoided when the patient is pregnant or pregnancy is suspected. Acupuncture is not contraindicated for anyone regardless of their pathology or what medications they are taking. Much research has been done on the connection between fertility and acupuncture. It may be the most commonly used alternative therapy of IVF patients. Some studies have found improved pregnancy rates among women who use acupuncture, while other research studies have not. In a study conducted in Germany and published in the journal “Fertility and Sterility”, women enrolled in an infertility program underwent acupuncture treatments just prior to and just after an embryo transfer into the uterus. Compared to women who did not have the acupuncture treatment, those who did had a significantly higher rate of pregnancy (42.5% vs. 26.3%). Moreover, almost all of the previous studies agree that acupuncture reduces stress and helps women relax.

Homeopathy

Homeopathy may be used in order to treat a variety of causes of infertility, including male infertility and female infertility. Each homeopathy treatment is individualized so as to suit the person’s specific needs, symptoms, lifestyle and health. Furthermore, specific remedies are used to treat different types of fertility problems.

The following remedies may be helpful in treating female infertility:
- Sepia 6c: irregular or absent ovulation.
- Sabina6c: recurrent miscarriage.
- Aurum: low sex drive and depression.
- Phosphorus: anxiety and stress.
- Silica: boosting the immune system in order to improve a woman’s chances of getting pregnant.
Moreover, the following homeopathy remedies are used in cases of male infertility:
- Sepia 6c: low sex drive.
- Medorrhinum: impotence.

Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) is a style of counseling that helps you replace negative thought patterns with more positive ones. CBT also includes learning deep relaxation and breathing techniques to reduce anxiety. There has been research on CBT and infertility, with a few studies finding improved pregnancy rates in couples who go through CBT. Other studies have not found improved pregnancy rates, but have found decreased rates of depression and anxiety. A study at Emory University in Atlanta, Georgia, has revealed that stress-related infertility can be reversed by CBT. About 5% of women of reproductive age have stress-related amenorrhea. Previous studies had shown that excessive exercise and under-nutrition could result in anovulation. The researchers wanted to look at why women developed such behaviours, finding that they were often a means of coping with stress. Therefore, a combination of daily life stresses can lead to amenorrhea in women, as well as infertility in men. Moreover, the women had been found to have high levels of the stress hormone cortisol in their spinal fluid. The researchers tested the impact of CBT on stressed women of normal weight who had suffered from amenorrhea for more than six months. The women were divided into two equal groups. One group received CBT. The sessions consisted of coaching on what is good nutrition, an acceptable level of exercise, what are realistic expectations, and ways to reduce stress. The other group received no therapy. A staggering 80% of the women who received CBT started to ovulate again, as opposed to only 25% of those randomised to observations. Furthermore, there was a decline in the levels of cortisol in the CBT group.

Laughter Therapy

Anything that gets you laughing is good for your mind and your body. Moreover, maintaining a sense of humor during infertility treatment can help you cope better. Research on laughter therapy has found it can help raise mood, lower stress hormone levels, possibly improve immunity, and lower blood pressure. Interestingly, according to a unique study which was conducted at the Assaf Harofeh Medical Center in Israel, making a woman laugh increases her chances that she will conceive. Researchers accidentally discovered that using humor and laughter almost doubled the conception rate, probably due to an alleviation of stress experienced by women undergoing IVF treatment. The study involved 186 women between the ages of 25 and 40. All were undergoing IVF treatment. Half the women were visited by a "clown doctor" during the critical period after embryo transfer whilst recuperating in bed. The other half of the women got nothing (the control group). The results were striking. Of the women who had the clown treatment, 33 became pregnant versus only 18 women in the control group.

Meditation

Meditation involves gently encouraging the mind to come into a calmer, more relaxed, focused state of being. It is not only about "clearing the mind" of all thoughts. Meditation can also be about letting your thoughts flow, without trying to stop or focus on one specific idea. Or meditation can be about focusing on your breathing or repeating quietly a specific mantra (a meaningful word or phrase). Α good deal of research has been done on the relaxation effect of meditation, and how it can help patients with chronic illnesses feel more focused and calm. However, little research has been done specifically about infertility.

Guided Imagery

Guided imagery is a form of guided meditation. It involves closing the eyes, and listening to either a therapist or recording guide you through a relaxation exercise that is rich in imagined images. According to many research studies, guided imagery can help cancer and trauma patients feel calmer and less anxious. Although fertility-specific guided imagery programs are available nowadays, there is no much research on fertility and guided imagery.

Hypnosis

Hypnosis is a mind-body therapy that involves going into a light sleep-like state, induced by a therapist. However, it does not always involve the use of a therapist. Guided imagery can act as a kind of self-hypnosis. Once in this state, the mind is highly suggestible, and the therapist helps the patient change negative thought patterns by suggesting alternative ideas. For example, obesity and smoking can lead to fertility problems. Research on hypnosis has found that it can help women lose weight or quit smoking. Moreover, hypnosis can help reduce stress and anxiety. There has been some preliminary research on the effect of hypnosis and fertility. One study found that hypnosis done during embryo transfer led to increased treatment success rates. Researchers at Soroka University in Israel aimed to discover whether hypnosis could make the embryo transfer stage of IVF more successful. During this stage, the embryo is transferred into the uterus. According to their results, 28% of women in the hypnosis group became pregnant compared to 14% of those in the control group. However, much more research needs to be done.

Yoga

Yoga combines physical postures (asanas) and breathing practices (pranayama) to create a meditative and relaxing exercise. It has been used for healing purposes for over 5,000 years. Yoga for fertility is rapidly gaining popularity. Fertility yoga is a specific branch of yoga, where certain yoga poses are championed for helping with infertility as they open up pelvis and hip joints, increase blood flow to pelvis and rebalance hormones. Some poses even claim to help to stimulate ovaries.To alleviate stress about trying to conceive, the cycle of fertility is to be mapped. When entering a fertile time, restorative poses are to be practiced, which leads to softening the abdominal area and removing tension from around the uterus, fallopian tubes, and ovaries. Of course, to benefit from the relaxation that yoga has to offer, you do not have to sign up for a fertility-focused yoga class. Any yoga class that emphasizes relaxation should work.

Massage Therapy

Massage may hold another key to reducing infertility stress. In research published in the journal “International Journal of Neuroscience” in 2004, experts found that massage therapy worked to decrease the body's physical signals of stress, including heart rate and brain waves. But, it was not tested on infertility patients. In Eastern medicine, reproductive organ massage, known as Chi Nei Tsang, is quite literally a massage of the abdominal organs. The goal of the massage is to cleanse, balance and relax the woman’s body, making it an ideal environment for conception.

Biofeedback

Biofeedback is a method of relaxation training. The therapist monitors your heart rate, perspiration, muscle tension, brain waves, and other physiological stress markers, tracking them with a computer. Then, he/she leads you through relaxation or mediation exercises, using the computer readings to help discover what works best for you to reduce stress. An informal method of biofeedback may include becoming more aware of your own body, without any computers or technology. For example, noting that your muscles are tense or that your heart is racing, you would know that you are becoming anxious or worried. You can then use relaxation techniques to help calm your mind and body.

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