When is the best time to have acupuncture for fertility?


Are you thinking of having acupuncture for fertility but unsure when the right phase of your menstrual cycle is to get the most out of acupuncture? Acupuncture for fertility can be beneficial at any of the 4 phases of your menstrual cycle. It can help with regulating your cycle and hormones, increasing blood flow to the uterus, aid with implantation and reduce stress and anxiety.

In Traditional Chinese Medicine (TCM) whatever the diagnosis we are treating we look to balance the body, we want yin and yang working in harmony and we want qi and blood to flow to all areas of the body and organs with no obstructions. We believe that when your body is out of balance issues can arise; with regard to fertility these issues can include but are not limited to endometriosis, polycystic ovary syndrome and pelvic disease.

Let’s look at the menstrual cycle and how TCM and acupuncture for fertility can be beneficial in each of the 4 phases.

Phase 1 – Menstruation (days 1-7)

Your period begins with the shedding of the uterine lining and flow of blood. From a TCM point of view, menstruation is the start of the growth of yin within the cycle and it is seen as the movement of qi and blood. The smooth flow of menstrual blood is important to prepare the uterus for possible implantation later in your cycle.

The length and regularity of your cycle, the amount of menstrual blood, its colour and the incidence of clots are all important for your TCM practitioner to know as these factors may contribute to TCM patterns of  yin or blood deficiency, stagnated qi and blood or heat which can impact on fertility.

During this phase, acupuncture can be used to regulate your cycle, it can address a heavy flow and any associated pain. It is used to start building yin. Specific acupuncture points can be used to balance any deficiencies or excess in the body.

Phase 2- Follicular phase (days 1-13)

Within a couple days of menstruation commencing the endometrial lining starts to regenerate as yin grows, oestrogen rises, and the pituitary gland produces follicle stimulating hormone (FSH) and luteinising hormone (LH) to stimulate follicle growth. One follicle will dominate and mature into an egg. Oestrogen will stimulate growth of the uterine lining and a surge in LH will begin progesterone production and prepare the follicle for ovulation, cervical mucous will develop. Yin continues to grow until it reaches its peak.

Yin is very important in this phase, it helps to develop a good quality follicle and egg for ovulation and cervical mucus to move the egg. If a dominant follicle does not develop in TCM this can be due to a yin and or blood deficiency. Yin or blood deficiency can delay ovulation and result in a long cycle.

Acupuncture can be used during this phase to continue to build and nourish yin and the TCM kidney and clear excess heat, it can be used to direct flow of qi and blood to the uterus to develop the endometrial lining and start warming the uterus. Moxibustion may be used to warm the uterus.

Phase 3- Ovulation (days 14-15)

The follicle has reached optimal size the endometrial lining is thick,  a surge in LH stimulates the release of the egg into the fallopian tube.

As ovulation occurs yin gives way to yang. The yin driven mucus gives way to a dry warm yang environment. The smooth flow of qi is important to move the egg into the fallopian tube. In TCM the heart controls the Bao Mai to keep the uterus open to accept the egg and the sperm. You can read more about the Bao Mai here.

Acupuncture is able to help ensure the smooth transition of yin into yang, boost yang, ensure good flow of qi, regulate the TCM heart and address stress and anxiety that accompany trying to conceive. Moxibustion may be used to warm the uterus.

Phase 4- Luteal phase (days 16-28)

The corpus luteum releases progesterone and oestrogen to thicken the uterine lining.

If a fertilised egg implants in the uterine lining (from 5 days post ovulation), progesterone will continue to be produced by the corpus luteum. The pituitary gland will be stopped from producing FSH and LH and hCG will be active until the placenta takes over.

In TCM if conception occurs it is important that the uterus is kept warm to create a nurturing environment for the foetus.

Acupuncture is safe during pregnancy (certain points are contraindicated) and the use of it during this phase if conception occurs will support the uterus and foetus, it will help to create a warm environment and maintain yang. Acupuncture can also help to address the symptoms of anxiety and stress during the two week wait.

If the egg is not fertilised the corpus luteum disintegrates and progesterone and oestrogen will drop causing the endometrial lining to shed and the cycle to start again with the menstruation phase.

As you can see, acupuncture for fertility is beneficial during all of the 4 phases of your menstrual cycle. For the best outcomes from acupuncture for fertility it is recommended that treatment is given for at least 3 full menstrual cycles with once weekly appointments being the ideal. Acupuncture has a cumulative effect with each session building upon the last. We individualise acupuncture to your needs throughout  all 4 phases of your menstrual cycle based on your signs and symptoms and TCM diagnosis.

If you have any questions about your menstrual cycle and any of the 4 phases and how acupuncture for fertility may be relevant for you, please reach out to us.

*The menstrual cycle is referred to as a 28 day cycle, in reality you might have a cycle that lasts anywhere from 25 to 35 days which is completely fine.

By Lisa Burnley – registered Acupuncturist

Source: Lyttleton, J (2016). Treatment of Infertility with Chinese Medicine (2nd ed.).Churchill Livingstone Elsevier.