If you are reading this article then you may already know that many couples are now finding that once they make the decision to start a family, all is not as straightforward as they thought it might be.  We now have 1 in 6 couples globally who are experiencing difficulties of some kind when trying to get pregnant, and these are the couples that we know of, so the first thing to say is that, sadly, you are not alone.  In addition to this, most of the medical investigations focus almost solely on the women!  What we now know is that fertility issues affect men just as much as women. Statistically, causal factors are usually 1/3^rd male, 1/3^rd female and 1/3^rd joint, which means, that couples have equal responsibility in taking care of their fertility health and well-being.

Some couples choose to use complementary therapies as part of their support or treatment planning when trying to conceive, but it can be difficult to know what is effective and how to find a reliable practitioner. The most commonly used are Acupuncture, Reflexology and nutritional support.

As a reflexologist and Chair of the Association of Reproductive Reflexologists, I would like to share our approach and some of our data in the hope that it allows you to make an informed choice about what you would like to use to support you on your journey to parenthood.

Reproductive Reflexology can offer, not only support, information and guidance, but also a form of treatment that can help couples to conceive naturally or support them when or if you do make the decision to undertake the varying forms of assisted conception, be that IVF, IUI or cycles of Ovulation Induction. 

Going back to basics and making sure that your fertility health is at its optimum can really pay dividends.  It usually takes around 3 months to fully prepare but is worthwhile as long as you don’t have underlying issues that mean delaying treatment is not an option for you. If you are concerned that this may be an issue then do discuss first with your medical practitioners, otherwise my checklist is below…..

1. Women – make sure that your menstrual cycle is functioning at its best, sometimes making the smallest changes can be all that is needed.
2. It might also help to have some base line blood tests i.e. FSH/LH/AMH and an Antral Follicle Count Scan to provide some basic information on your fertility health.
3. Men – your role is key to making good healthy embryo’s, so make sure that you get a thorough Semen Analysis, and consider a test for Sperm DNA Fragmentation.
4. Take a look at your diet and nutrition, including alcohol, smoking and caffeine intake.
5. Take a good supplement that provides therapeutic levels of the vitamins/minerals needed for optimum fertility health.  Ideally, one that has some evidence/research behind it.
6. Take care of your stress and anxiety levels as these can have an effect on menstrual cycles and sperm health.
7. When looking for any kind of practitioner or clinic, do your homework and find the clinics who are going to provide what is best for you and the practitioner that is best qualified and you feel most comfortable with. Make sure that you speak to at least 3 and read reviews too.  For complementary practitioners ensure that they are a member of a relevant governing body and are properly trained and insured.

One of the most fascinating things is how little women know about their menstrual cycles.  As women, we mostly rely upon what we were taught at school, and unfortunately, this can be sorely lacking! There are so many ‘false facts’ about menstrual cycles like ‘all cycles should be 28 days long’, ‘every woman ovulates on day 14 of her cycle’, ‘ if a woman is menstruating, she is ovulating’! 

One of the starting points in using reproductive reflexology as part of your fertility journey is to help each woman to understand her own individual menstrual cycle and help to identify any issues that might be causing a problem.  There can be a wide range of issues, even in women with a ‘standard 28 day cycle’ that they may not be aware of.  These can include progesterone deficiency, a short luteal phase (post ovulation), anovulatory cycles (no ovulation) to name a few.  Once identified, these issues can be resolved and managed using reflexology.  And once women understand their menstrual cycles better, then they are able to identify the optimum time during which they are at their most fertile.  What most couples are not aware of is that having sex in the days leading up to ovulation is THE most important time. An egg is usually only fertile for about 8-12 hours, so ensuring that sperm are in situ prior to ovulation increases success rates. 

And, of course, we must not forget men! 

Sadly, most men are very poorly informed about how they produce sperm and how important reproductive and sperm health is.  It takes about 3 months for sperm to be produced and ready for their role of fertilizing the egg.  But, many things can happen during this period of time that can affect the quality and quantity of the sperm. These can be as simple as higher than average stress levels, an infection or even high levels of exercise, and certainly alcohol, smoking, caffeine and drug use can all have an effect. 

The head of the sperm contains the most important information of all – the DNA – this is fairly delicate and can be easily damaged. If the strands of DNA fragment (develop small breaks) then this can be a major contributing factor in recurrent early miscarriage, failed IVF cycles and being unable to conceive.  At low levels it can be fairly easily remedied by reducing stress levels, cutting out alcohol and caffeine and making dietary improvements, including taking a good quality supplement, specifically designed to protect against damage.  At higher levels, it becomes more difficult to treat and then it becomes useful to know what treatment options are available for you as a couple, as it doesn’t mean that it is the end of the road, just that you may need different support.

Sperm take between 45 minutes to 12 hours to make their difficult journey to the end of the fallopian tube, but can survive for up to a week in the right environment.  They then rest in suspended animation until ovulation occurs, as the ovum is released the sperm become active and ready to fertilize the egg.  So, making sure that they can swim well, and are at their absolute best, makes sense.

Reflexology can be a useful tool in improving sperm outcomes and reducing and managing stress and anxiety. We usually begin by suggesting that you have a detailed semen analysis at the start of reflexology treatment to identify any issues and then re-testing once treatment has been completed helps to measure progress.

Reproductive reflexology can be a useful and effective form of treatment for improving fertility issues and outcomes.  It is non-invasive, pleasant to receive and provides many other health benefits and for those of you worried that it might be ticklish….. we never find that a problem.

Over the years reproductive reflexology has helped many couples to become families and we have much anecdotal evidence that supports this claim.  However, we are always keen to seek evidence to see whether this is the case and there are many research projects currently being undertaken to provide further information on how, why and whether it works!

The Association of Reproductive Reflexologists undertook a data collection study of 180 clients, who were receiving reproductive reflexology whilst trying to conceive.  

And here is the data….

100 Natural Conceptions

22   with IVF/ICSI

Age Range 24 -46

Average Number of Treatments 11.32

 68% conceived whilst receiving treatment.

Pregnancy with IVF/ICSI 52%

We also looked at a variety of conditions, and how they responded to reflexology, including male fertility issues and responses to IVF/ICSI, with positive results.

I hope this has helped to allow you to make an informed choice about whether you would like to include reflexology as part of your fertility journey. If you would like further information about how we work you will find this on our website.

I wish you a calm and positive journey.

What is it? PCOS is a wide and complex condition with a general set of accepted symptoms, which are also individual to each woman.  This can make it difficult to diagnose. It is also one of the most common reproductive conditions to affect women, so if you have been diagnosed or suspect that you have PCOS then you are far from alone. Studies show that somewhere between 10% and 20% of all women have PCOS. In the UK it is thought that 1 in 5 women have PCOS.

In an Australian study of women (aged 28-38) diagnosed with PCOS, the time to diagnosis was between 1 and 17 years.  Most had self-diagnosed by researching their symptoms using the Internet.  This in itself can be distressing, so being given a formal diagnosis can be a relief, but also a cause for distress. It does allow for effective planning in terms of managing symptoms and exploring what treatment options are available. This means that patients can have meaningful and constructive discussions with their Gynaecologists, Fertility Consultants and Complementary Therapists for improving fertility naturally and also what forms of assisted reproduction or ovulation induction techniques would be most beneficial.

Before we move on to symptoms and relevant diagnostic testing, I would just like to mention that I do see many women who have episodes of PCO (Polycystic Ovaries) which can be related to stress which causes very irregular menstrual cycles and disrupts ovulation and can therefore cause periods to stop altogether.  The ovaries can appear to be cystic when scanned.  However, with treatment and stress management, the cycle can fairly quickly return to normal.

Symptoms of PCOS may include…

Irregular periods, and this may mean very long cycles, followed by a shorter cycle i.e. 85 days and then 30 days. It could also mean just having 2-3 periods a year, or sometimes none at all for very lengthy periods of time.

Polycystic Ovaries – ovaries that are enlarged, and contain many follicles (the fluid filled sacs that contain eggs) Although these are called ‘cysts’ they are technically just normally occurring follicles, which don’t develop beyond 8mm in size and therefore do not rupture to release an ovum.

Excess Androgens – higher than normal levels of Testosterone and reduced levels of SHBG (Sex hormone Binding Globulin) which is a carrier for reproductive hormones.

Excessive hair growth – Hirsutism, particularly on face, chest, buttocks and back.

Difficulties managing weight, this can be particularly distressing as weight gain in itself can then impact further on the menstrual cycle and ability to conceive.  However, not ALL women have difficulties with managing weight.

Skin Problems, in particular Acne and Acanthosis Nigricans (brown patches)

Hair loss- or thinning hair

Depression

Increased skin tags

Fatigue – due to fluctuating hormone levels

Poor sleep

Insulin Resistance – Insulin resistance involves the body’s inability to lower blood sugar levels correctly. Blood sugar levels can become too high, which causes yet more insulin production. Too much insulin also increases testosterone production, which, in turn, leads to further disruption of the menstrual cycle.

An increased risk of miscarriage- as if the symptoms of PCOS and difficulties trying to conceive are not enough on their own, there is sadly, an increased risk of early miscarriage and pregnancy related conditions.  This includes pregnancy related hypertension, gestational diabetes, pre-term birth and pre-eclampsia.

Diagnosis is usually confirmed if patients experience two or more of the main symptoms, which include lowered SHBG and increased Testosterone, an irregular menstrual cycle and observed polycystic ovaries.

What Causes PCOS?

• A family history, particularly if your mother or sister have already been diagnosed.

• An Increase in visceral fat around the abdomen and obesity.

• Elevated Insulin levels.

Why does it Impact upon Fertility? One of the main reasons that PCOS affects fertility is due to infrequent or complete lack of ovulation (anovulation).  If ovulation is sporadic, this can make it very difficult to identify when ovulation is actually taking place and this then makes it difficult to ensure that you are having sex at ‘the right time’.

Weight gain associated to PCOS tends to be around the middle and is known as visceral fat.  This in turn can secrete its own kind of oestrogen which can then further disrupt the ability to ovulate.

Can I Improve my Symptoms and Chances of Conceiving? The good news is that there is much that can be done to improve your chances of both getting pregnant and maintaining your pregnancy, and also managing some of your symptoms.

Regulate your menstrual cycle 

The most common medical approaches are to use drugs such as 

Metformin – to stabilize insulin and which may then restore ovulation and or Clomiphene Citrate or Leterazole to increase the likelihood of ovulation occurring.

Additionally, Ovarian Drilling, a laparoscopic procedure has been found to be of benefit.  This is a surgical procedure which uses heat or laser treatment to destroy tissue in the ovaries and has been found to lower testosterone, Luteinising hormone and raise Follicle Stimulating Hormone.

However, there are many more natural approaches to regulating your cycle, that have fewer or no side effects.  Both Acupuncture and Reflexology have reported excellent results in restoring ovulation and a more regular menstrual cycle, with research and data collection studies to support this. Some herbal remedies, including Agnus Castus have also proven to be of benefit.

Reproductive Reflexology, in particular, uses structured protocols including ‘homework’ on the hand reflexology points, alongside monitoring of your menstrual cycle to measure progress.

You could also consult a Fertility Nurse who specializes in supporting women with PCOS, this can be particularly helpful in guiding you to understand your own menstrual cycle.

The most important factor is to try and establish a regular cycle, even if it is long, this will help in making sure that you are able to take advantage of your fertile window. When a menstrual cycle is irregular, it is in the main due to fluctuating ovulation.

Understand when you ovulate – This is key to helping you to optimize your chances of conceiving when you have a PCOS diagnosis.  Charting your Basal Body Temperature (BBT) or using an ovulation monitoring device like Ovusense means that you are likely to have a much better understanding of your cycle and when you are most likely to be fertile.  The fertile window in the cycle is short, usually around 2-5 days, so ensuring that you are able to identify this will increase your chances of conception. 

There are websites which can help with plotting BBT graphs, and noting your ovulation signs. I usually recommend a free website www.fertilityfriend.com which provides a wealth of knowledge and support, including sample PCOS charts so that you are able to identify what you are looking for.

Once you have started to chart your cycle, you will also be able to add in your own individual ovulation signs.  These may include…

Changes in Cervical Mucous – CM that becomes more profuse, watery, clear, stretchy or can be likened to egg white.

• An increase in libido
• An increase in energy levels
  
• A dip and then sustained rise in your BBT
• One- sided abdominal pain – a slight twinge, that relates to the rise in temperature on your BBT chart
• Spotting – which is minimal and also relates to a rise in your BBT
• Breast tenderness – some women experience this for 2/3 days around the time of ovulation

You may have other symptoms that indicate ovulation which are individual to you and BBT charting will help you to identify these.

The more knowledge you have about your own menstrual cycle, the more empowered you are, and the greater your chances of conceiving without further intervention.

I usually then recommend having sex 3 times in the week leading up to ovulation, so that sperm are in situ before ovulation occurs.  

Manage Weight – I have purposely left addressing the issue of weight until last as I know that it can be so upsetting for women.  It is the one thing we know that can make a real difference.  Even losing 5% of your body weight can help to re-introduce a regular cycle.  However, for women with PCOS it can be one of the hardest things to do.  In fact, it can be incredibly distressing.  If you are struggling please do seek the advice of a nutritionist who will be able to provide an individual approach. 

Changing eating patterns to include one of the following can make it easier to lose weight and maintain it. 

Low glycemic index diets

Blood/sugar diets

5:2 fasting diets (or other forms of this)

These can help to regulate insulin levels and make it easier for you to lose weight.  Don’t forget to include some exercise, even a good brisk walk each day will help to keep you active and make it easier to manage weight, and improve sleep and energy levels.