DAY OF EMBRYO TRANSFER
The Scoop On Acupuncture
This post was updated to reflect the most recent clinic policies at various Twin Cities fertility clinics as of April 22, 2016. Because each of the clinics in the Twin Cities does it slightly different you'll see that certain parts of this post are now divided up by location and cycle type to make it less overwhelming/confusing!
It's hard to believe I'm coming up on 10 years in this amazing career! From the get go, supporting women who are undergoing IVF (In Vitro Fertilization) on the day of their embryo transfers has been one of the most special and rewarding parts of my work. It is the day you have worked so hard for and been through so much to get to. I am touched you would consider inviting me in and thrilled when you do!
If you are considering acupuncture on the day of your embryo transfer, here are the basics you need to consider and know, as well as some extra layers if you want to dig in deeper.
What, when, why.
In an IVF, acupuncture is often done the day that the embryo(s) are put into the woman's uterus. In most studies - I'll cover more on the research in a bit - acupuncture is done twice. Once before the embryo transfer, then again after. So two acupuncture sessions done relatively close to one another are the norm in studies*.
" It's okay to feel good about doing what is right for you. "
*Based on the studies (read on for links and actual stats), it'd be nice to do some sort of acupuncture relatively soon before and after the embryo transfer, but we know the date until anywhere from a couple weeks in advance to the afternoon before (keep reading for the logistics of scheduling). In the real world this boils down to having as many options to choose from as possible and then picking the ones that actually sound like they would make a woman and couple feel more supported, balanced, and sane. And in turn, skipping the ones that make them feel like desperate crazy people who are running around doing what a study tells them to do. There isn't a one size fits all, there's just a version that makes you feel the best and that's what you should do! Honestly, it's not about what you do or don't do, it's about how it tips the scales. I have done this for 10 years and I don't see one magic version that trumps the rest. It's okay to feel good about doing what is right for you.
Should acupuncture be appealing, I plan my normal patient schedule under the assumption that I'll be doing a fair amount of on-call acupuncture for day of embryo transfers, and that most embryo transfers happen prior to 2pm. I see patients at my clinic mostly in the afternoons and evenings, so my schedule is open on Monday mornings until noon, all day Tuesdays, Wednesday mornings until noon, all day Thursdays, and most weekends. During these times is is generally easy for me to do on-site acupuncture for embryo transfers in some capacity. If I know your date and my first one or two appointments are not already booked at my clinic I am happy to block off my schedule until 1 or 2 in the afternoon to give you the most options. The further in advance I know the tentative date of your transfer the better! In 10 years there are very few day of transfers I couldn't make something work, and I have a backup in case.
If my schedule and your exact timing doesn't work for any reason, we will chat about alternative options. I can see you the night before or earlier in the morning at my office, do house calls while you are on bedrest, etc. I also have a main backup colleague (Gina Fabiano at Heal OM) who is completely trained in my unique methods who can provide you with her options. There are several other great referrals who I know you'll be in good and experienced hands working with if neither my main backup or I work. This has only happened twice in 10 years!
Why might acupuncture be right for you.
- 1 -
As I mentioned, there is some great research showing that it can be helpful. In general. the average of the studies seems to show about a 10% increase in success with those doing acupuncture vs not. Ways acupuncture can help improve outcomes is by normalizing hormones, improving uterine blood circulation, and relaxing the cervix so the transfer is smoother. Those who seem to benefit the most from acupuncture during their cycles are those who are "poor responders" and those who do even more customized acupuncture (whole systems acupuncture) leading up to their IVF. So if you are reading this enough in advance to start a month or two prior to your IVF, even better. If not, there's no time like the present! At Life Healing Life my day of embryo transfer success rates are over 80-90% for patients we have worked with me in advance (fresh and frozen cycles vary), and between 60-75% for those I only see on the day of transfer (again with frozen having better results than fresh). This is a really big deal, which I attribute not only to the acupuncture, as the research shows that's just a 10% boost over the clinic success rate. But to everything else we do, which is all unique and pioneered by me (we'll cover those in #2). Wherever you are in the process do what you can and what feels right, it's really okay!
" Doing acupuncture should make you feel more supported, more relaxed, more empowered, more sane. "
One thing I really stress with prospective patients is there are a few studies where acupuncture seemed to decrease the odds of success. In every case, the conclusion of the study says that the stress of the extra running around, fear of needles, having acupuncture done by a stranger, etc canceled out the good of the acupuncture and then some. So if running around, getting up extra early, worrying about time, etc stress you out, don't feel bad about saying no to acupuncture. I've even talked some women out of doing acupuncture, when I realized they clearly sounded stressed about it. I wouldn't feel comfortable seeing them, because my Hippocratic oath is to "do no harm." So really consider this. Doing acupuncture should make you feel more supported, more relaxed, more empowered, more sane. If you want acupuncture and we've never met, feel free to pop into my office to say hello (email to set something up), or do a single treatment with me in advance. At the very least, we will have a nice phone chat to make sure you are "feelin' me"!
- A -
Instead of being completely amped up and stressed out going into the transfer or back home again, you'll be not only getting acupuncture, but also in a candlelit room, getting massaged, listening to relaxing music, having someone to talk to about how you are feeling, having a chance to talk, cry, feel validated, getting ideas for self care, and doing something to take care of yourself. This is what this day should be about. You and your tender heart and journey to this big day! I always honor that. I've heard from many women who say way before ever finding out the outcome of their cycles, that doing acupuncture on the day of transfer was worth every penny because it made the day feel so much more TLC filled, connected, loving and reassuring, vs clinical, procedural and stress-filled.
- B -
In addition to self care, acupuncture sessions create some special time to connect with your partner, if you have one. After all, this is about making a baby together and your love and desire to be parents, lest we forget with all the technology and schedule! I was recently at a clinic where they track the time in and time out for each acupuncturist who comes on site. As I looked up and down the list I noted some acupuncturists were on site for as little as 30 minutes. That feels like just another rushed, procedural approach and isn't the Life Healing Life style at all. My pre/post transfer sessions include monitoring and phone calls prior to your transfer, and 2.5 - 3 hours of on-site time when we do both sessions at your fertility clinic. I want to make sure every couple I work with has time to hold hands, talk, breathe, say a prayer, cry, tell jokes (you laugh, but there is research on laughing the day of embryo transfer!) ... you name it. Whatever feels right to them. Instead of just rushing into the clinic, going through a clinical feeling process and going home, it carves out some time to make it special and loving and sweet. You can totally do this yourself in many ways throughout your cycle too and I highly encourage it whether you work with me or not.
- C -
Your acupuncture session will also be a mini-coaching session to help you prepare for the two week wait. I believe I can promote balance with my needles, but there's the risk of you walking out the door and undoing it all. But with the right information you can help sustain and support that balance and feel empowered, stronger, and capable. These feelings can sometimes be hard to come by when you've been through so much hardship and failure to get to this place. We will go over ideas to help you cope with the stress of waiting for your results, help you understand the science (just a bit) of what's happening in your body by engaging the mind part of mind/body, and more. This can be a lovely thing and help you stay sane during the tough, "am I or am I not" boob grabbing, toilet paper scrutinizing phase! If you don't end up seeing me, but want some of these ideas, you can check out my article and do them on your own too!
Not all day of embryo transfer acupuncture is created the same. Beyond the above extra time and TLC, do make sure you get a good feel about whoever you work with, and that they actually make you feel better, not worse! Heck, that's ditto for working with me! I've got a little write up about some of my biggest pet peeves when it comes to day of transfer IVF that I hope you'll look over and consider so you won't get tripped up by rotten suggestions.
Locations and Schedule Overviews
CRM - Chicago Ave, Minneapolis
1.5 hours prior to transfer meet at CRM for the PRE session. We'll do some education, Q&A and needles, you take valium during this time and drink water - I'll prompt you.
- Remove needles 1/2 hour prior to transfer when the nurse will admit you.
- Nurse brings you back and gets you ready for transfer.
- 10 minutes of laying down, then get up and use the bathroom.
- Rest for 20 more minutes at CRM on heated table.
- Either go home for more R&R, or go to the Life Healing Life clinic for the post session.
Effective April 15th, 2016 due to clinic volume and room availability the Center for Reproductive Medicine (CRM) will only allow only one acupuncture session per IVF on-site. So either a pre OR a post, but not both. This is a bummer, but the alternative of feeling stressed and shuffled around, not having a room available at the right time, etc. would be an even bigger bummer. Thankfully it usually works to do the pre IVF session at CRM which is definitely my preference of the two. If we do the pre at CRM (rather than my clinic) then you don't have to worry about leaving from acupuncture and driving through traffic and dealing with parking, being rushed, etc which I think undoes some of the bliss of the pre session! When we do the pre session at CRM it means you can already be right where you need to be, relaxed and holding hands with your partner, listening to relaxing music, candles lit, and laying back while the acupuncture needles and Valium work their magic. Acupuncture needles are removed just prior to the nurse coming to get you for your transfer (1/2 hour prior to your transfer time). If the clinic is running a bit behind? I just stay in the room and massage you and keep you in the zone - nice! Then, we can either skip the post or Life Healing Life is located just 3 blocks from CRM and has ample parking, including valet off-street, So it can still work for patients to come to Life Healing Life for the post session. In fact, there's even a wheelchair you can have your partner wheel you in if you don't want to walk from the heated garage to the office.
CRM gives their patients the time of their transfer the afternoon before the actual transfer. So give me the date as soon as possible. For fresh cycles we can tell once you know when you will trigger, so email me as soon as you have your trigger scheduled. For frozen cycles you will get your date ahead of time, but the exact timing still comes down to the afternoon prior. We just fly by the seat of our pants and talk options in advance and firm up plans when we can. Email me all time-sensitive updates.
CCRM - France Ave, Edina
- Arrive 1.75 hours prior to transfer and have blood work drawn.
- You are brought to the one room you'll be in the rest of the time for the pre session.
- At some point in the first 35-40 minutes we will do some education. The embryologist will give you an update and you will get your vitals done and get your valium.
- I put needles in and we do the pre session while you sip water.
- Remove needles about 15 minutes prior to tranfer.
- Nurse preps you for transfer.
- Rest 15 minutes, then empty your bladder.
- I come back into the room and do the post session and time it to end around your discharge time, which is 1 hour after your transfer.
- Home for R&R.
We can do both treatments right on site in the same room you'll do your actual transfer at CCRM. CCRM Colorado is a big advocate for acupuncture, so they're super down with the pre/post. Candles, check, music, check, coziness, check. CCRM's transfers are typically around mid morning to midafternoon so I can almost always (except Fridays) make at least the PRE treatment work (and usually the post too with a bit of notice in advance). For fresh cycles we can tell the date once you know when you will trigger, so email me as soon as you have your trigger scheduled. For frozen cycles you will get your date ahead of time. CCRM gives their patients their transfer times a few days in advance (sometimes more), so just let me know as soon as you hear from them and we can plan a bit more in advance.
At CCRM you'll arrive and have your blood work done approximately 1.5 to 1.75 hours prior to your transfer, then you'll come back to the transfer room where you'll be the rest of the time. You will meet the embryologist, have your vitals done, then we'll chat a bit and get needles in as your valium is also kicking in. I'll take your needles out just before your bladder check (about 15 minutes prior to your transfer) and massage you until the nurse comes in to make your final preparations for transfer. After transfer, you'll lay down for 15 minutes, then be allowed to empty your bladder. Then I'll come back in and do the post. CCRM wants you to lay at the clinic for 1 full hour after the transfer, so I usually just make the post extra long and get the needles out just before you are discharged. A nurse will wheel you down to your vehicle and you'll be home for bedrest.
RMIA - Woodbury or Edina
- Arrive 2 hours prior to transfer.
- We do some education and Q&A and get needles in for the pre session. You will sip water while your needles are in.
- Needles are removed 1 hour prior to your transfer. You will then take your valium and the nurse will take you to prep for transfer.
- You will rest 15 minutes, then empty your bladder and come back to me.
- We will do the post session and you will be done about 40 minutes after we start, which is about an hour after your transfer.
- Home for R&R.
At RMIA we can do both treatments right on site but the location within the clinic varies (a bit). Most often it will be done in the recovery area of the clinic (where you would have recovered post retrieval), but depending on clinic schedule we may be shifted into a recliner or office space and will make it as comfy and cozy as possible. RMIA's transfers are typically in the first part of the day (but not always), so I can almost always (except Fridays) make a PRE treatment work. For fresh cycles we can tell the date once you know when you will trigger, so email me as soon as you have your trigger scheduled. For frozen cycles you will get your date ahead of time. RMIA gives their patients the time of their transfer the afternoon before the actual transfer. Just give me the time as soon as possible via email.
RMIA wants your needles to be out a full hour prior to the transfer, so this means we will meet two hours prior to your transfer time to start your pre. This means RMIA sessions start earlier than the other two clinics, but this usually works just fine with my schedule as I only work one morning per week (Fridays) at my clinic.
Important Stuff For All Locations
If you are communicating anything relating to your IVF, please always email me the info. My voicemail and texts occasionally do not get to me right away. They seem to get hung up in the ether and I occasionally do not receive a text for a day or two after it was left. This will not do for IVF!
The pre session is the one I feel is the most valuable. The pre is all about blood flow and calming nerves and is a chance for couples to feel intimate and connected, instead of running around in the car. So, if you do not do the pre, I do recommend you think of ways to bring this same energy into your experience - arrive at the clinic early and go for a stroll holding hands or sit in the car and breathe in the parking structure while playing a song from your wedding.
The post session is about supporting hormonal balance and the woman is often a bit out of it (the valium plus the big relief of getting through the transfer = nap time for many women). So if you want to do a post session there is still good work to be done and that's great, but if not or it doesn't work to, don't worry! Either way works. In fact, for the first 7+ years of my practice most clinics didn't allow any onsite acupuncture (except RMIA) and women would come to my office or have me do house calls for both treatments the day of their embryo transfer. Often they'd only do one or the other and it was still super helpful. We'll take what we can get and make it work! I'd much rather do it as well as possible given real limitations than try to force something that just isn't set up to work. We can still make your big day awesome!
If this info is helpful and you want to chat more, please send me an email at firstname.lastname@example.org and include your phone number and we can touch base and talk more. I'd love to be a part of your big day!
Disclaimer: These recommendations and ideas are based on my own practice and the fertility clinics I work most often with. Some variables exist and can be addressed once I know more about you, your cycle and which clinic you are working with. If you are looking at this information and are not in the Twin Cities or planning to work with me, I recommend you confirm or get more info from your actual provider and do not rely solely on this article.