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 1, 2018. 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!
Since the start of my practice, 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 know and consider, 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. 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 you feel more supported, balanced, and sane. And in turn, skipping the ones that make you feel like a desperate crazy person who is running around doing what a study tells them to do while losing your mind! 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 as I do about 1 - 2 per week. I am generally available for IVF treatments:
Mondays until noon
Tuesdays until 3p
Wednesdays until noon
Thursdays until 3p
I do prioritize patients that I have been working with and have seen at my clinic, and only add a set number of additional 'stand-alone' IVF patients per month. If you are only looking for day of transfer care, feel free to reach out, but know that I may need to refer you if these spaces are already filled.
The further in advance I know the tentative date of your transfer the better! In over 10 years there were very few day of transfers I couldn't make something work, and I have a backup just in case. Email is always the best way to communicate with me.
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, use stick-on needles* to do the post transfer acupuncture points if I need to return to my clinic to see patients and can't stay the whole time, etc. I also have a main backup colleague (Gina Fabiano at Heal OM) who is completely trained in my unique education-methods who can provide you with her availability!
*I use stick-on needles for POST sessions fairly often. These needles are small and attached to a band-aid like piece of tape. You can see a video of them here. Utilizing these needles allows me to still offer a full set of POST transfer needles on days when my schedule doesn't allow me to stay at the IVF clinic the full time. In these cases we would use traditional acupuncture needles for the PRE session, remove them and then, depending on timing place a second set of stick-on needles in the POST transfer points and either just before or immediately after the transfer. I can then leave and make it back to my clinic to see patients and YOU remove these needles at home either later the same day or in the following days post transfer. They are discarded in your sharps container. If you use these needles I will email you care instructions and remind you of the locations.
Why might acupuncture be right for you.
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 of those doing acupuncture vs not. Acupuncture can help improve outcomes 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 I add into the typical protocol. Acupuncture is the base, but there are so many ways additional to make it even better!
" 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 acutally 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 this applies to you, don't feel bad about saying no to acupuncture. I've even talked some women out of doing acupuncture when I realized they were very 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 and more sane.
What makes Life Healing Life better.
Pre-Transfer Education - You'll get both in-advance and on-site education - from what to expect on the big day, to bladder prep basics, implantation and embryology 101, and how to cope with the pressures of the two week wait and beyond.
Consistent Communication - I spend 2 hours per day communicating with patients between visits. I check in the day before transfer with prep info, after the transfer with an email follow-up filled with resources and reminders for self-care, and in the 2 week wait to see how you are holding up. If you let me know you have had success I've even got an early pregnancy after IVF packet I'll send your way!
The Little Things - From candles and dim lights, to music and massage. Undeniably, an IVF transfer is a scientific wonder, but it is also about a couple's love and welcoming a baby into a woman or couple's life. I like it to feel like both!
Customization - My success rates are higher than most acupuncturists because I never stop with a protocol or one-size-fits-all approach. I start with the foundation of IVF transfer support, but always add layers that serve the individual. Every transfer is uique and personal.
If you can't work with me, there are some ideas I want every woman and couple to have.
Locations and Schedule Overviews
CRM - Chicago Ave, Minneapolis
1.5 hours prior to transfer meet at CRM for the PRE session. We'll have a private exam room, time for 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 come to admit you.
- Nurse brings you back to the IVF side of the clinic and gets you ready for transfer.
- 10 minutes of laying down in the transfer room, then get up and use the bathroom.
- Rest for 20 more minutes at CRM on heated table.
- Either go home for more R&R (with or without the stick-on needles for your post points), or drive just 3 blocks 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 pre-transfer acupuncture session per IVF on-site. 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.
CRM is by far the hardest clinic to schedule day of transfer care for because they don't assign their transfer times until the day before by 2pm, they do transfers from early mornings to later afternoons and early evenings, and they dont' have a room for acupuncturists to do post sessions on site. Many acupuncturists have stopped offering day of transfer care at CRM because it's a bit of a ligistical challenge. I still do my best to offer as many options as I can, but please know that they may be limited, especially if your transfer time is later in the afternoon or evening. I encourage CRM patients to share their feedback and desire to make acupuncture a part of ther transfer care with CRM. If they get enough feedback they may consider making their process more holistic-friendly in the future.
CCRM - France Ave, Edina
- Because there is limited education time on site, all CCRM patients must do an educational phone consult, for no additional charge, prior to transfer for the education portion of their care.
- 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.
- The embryologist will give you an update and you will get your vitals done and get your valium - the order of this varies depending on the clinic flow.
- I put needles in and we do the pre session while you sip water - I'll guide you.
- Remove needles about 10 minutes prior to tranfer.
- Your bladder is checked.
- Rest 15 minutes, then empty your bladder.
- The post session acupuncture is done and I'll time it to end around your discharge time, which is 1 hour after your transfer. If I need to be back to my office we can talk about sticker points for your post session.
- Home for R&R.
CCRM is a big advocate for acupuncture and will even prescribe it for some patients with uterine blood flow concerns, so they're completely down with both the pre and post and make it easy! Because most transfers here are frozen transfers, we get dates and times in advance and can confirm them after the final lining check which is 6 - 7 days prior to transfer. CCRM also does all their transfers from mid-morning to mid-afternoon so I can almost always (except Fridays) make at least the pre-transfer treatment work, and usually the post too with a bit of notice in advance.
RMIA - Woodbury or Edina
- Arrive 2 hours prior to transfer.
- We have ample time for some education and Q&A, then you'll get needles in for the pre session. You will sip water while your needles are in - I'll guide you.
- 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 10 minutes, then empty your bladder and come back to me, or go home for more R&R (with or without stick-on needles for the post-transfer session.)
- If we are doing the post session on site you will be done about 40 minutes after we start, which is about 1 hour after your transfer.
RMIA is in the middle as far as ease of scheduling goes. While we get dates in advance sometimes, they do more fresh transfers and we have to fly by the seat of our pants as to whether it will be day 3 or day 5 transfers. They also require acupuncture to start earlier and be done a full hour in advance of the transfer, so doing a full on site pre and post takes closer to 4 hours. We will talk more details once you get your exact date / time and I'll do my best to give you what you want!
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!
If this info is helpful and you want to chat more, please send me an email at email@example.com 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.