As we know, Assisted Reproduction is a multidisciplinary branch. This means that its treatments often integrate complementary therapies. Today, we approach reflexology and, for this, we wanted to take advantage of  Barbara Scott’s and her colleague Harriet Combe’s visit to solve a handful of queries.

How would you define reflexology? 

Reflexology is a form of complementary therapy that has been in existence for many thousands of years, and is still frequently used in its originating countries of Egypt, China and India.  I always explain it to my clients as working in a similar way to acupuncture, in that we are working with energy that flows through the body in what are called ‘meridians’. These ‘flows of energy’ become blocked and the relevant affected part of the body becomes unable to function as well as it should.  In acupuncture terms, needles are placed directly into these ’flows of energy’ and with reflexology we access them by working with precise areas called ‘reflex points’ on the feet, hands or ears.  It sounds a little strange but there are now increasing numbers of pieces of research that show how effective it can be.

Why do you think holistic therapies are important with respect to infertility? 

Fertility issues are complex and varied and can have many causal factors.  Holistic therapists have the luxury of being able to spend time with patients, this allows them to explore many avenues that may have been overlooked, including the impact of stress.  We know that stress can have a detrimental effect upon both the endocrine and therefore the reproductive systems in both men and women, so even managing stress levels themselves can have a beneficial effect.  Having time with patients also allows them to explore the emotional aspects that having difficulties with conceiving can cause and this is so important to address and can make their fertility journey easier.

What do you love most about your profession?

As Reproductive Reflexologists, we use an evidence-based approach, which means that we rely upon medical tests to help us to determine where the underlying issues may be and these help us to plan effective and appropriate treatment. These may include relevant blood tests and semen analysis, we also use repeat testing to help us to measure ongoing progress.  I absolutely love my initial consultation with each client, particularly when working with men too.  Using a forensic approach to allow us to bring together all of the pieces of the jigsaw puzzle to find the ‘Aha’ moment, really makes my work worthwhile.  And when we get a positive result, my heart sings for the patient.

We have been reading the several case studies you posted in your website and we noticed that you also encourage your patients to change their nutritional habits and lifestyle. Why are those aspects useful?

There is so much research that shows that nutrition and lifestyle can have both negative and positive effects upon fertility for both men and women.  And we know that this is just as important for assisted conception and receiving donor eggs as much as for natural conception. I also feel that making small but significant changes can be very empowering for patients as they can feel that there is something constructive that they are able to do to help improve their chances of conceiving.

Do you often find people who do not “believe” in this set of methods?

We do tend to find that men are more sceptical than women about using any form of complementary therapy as part of their fertility journey.  However, once we have met couples or singles at an initial consultation and they can see that we use a science-based approach we find that attitudes change.  Although it can seem very strange to think that having your feet worked upon can have a beneficial effect upon the rest of your body, our data shows that 68% of patients conceived whilst using these techniques. That really speaks for itself!

How would you define your experience in Clinica Tambre during your visit?

I can only say how incredibly impressed I was with our visit, from beginning to end, everything has been carefully thought about.  The clinic itself is patient-centred and provides a calm and thoughtful approach to ensure that stress levels are kept to a minimum. From the idea of providing individual ‘pods’ for the waiting area for patients to ensure privacy, through to the delightful ‘bedrooms’ for pre/post treatment was perfect.  The thorough testing for each patient and an individualised approach to treatment speaks for itself in your success rates. As an organisation we have a passion for patient care and ensuring that the journey for each individual is as positive as possible, and it is evident that Clinica Tambre share that passion.  I have no qualms at all in referring patients, knowing that they will be well taken care of.

ReproflexologyTM  (Reproductive Reflexology) is the study of and treatment of male and female reproductive conditions and fertility issues using reflexology.

One in six couples in the UK are now experiencing difficulties in conceiving, in addition to this, male fertility has declined by 50% in the last 25 years.  This pattern appears to be replicated not only across Europe, but the rest of the world and even in developing countries, not normally associated with fertility issues, couples are finding that they are having difficulties getting pregnant.  

There are, of course, many complex factors involved in the casual factors for both male and female fertility.  Male fertility is still marginalised by fertility clinics who very much focus on the female, when what we know is that fertility issues are attributable proportionately, a third male, a third female and a third joint.  This means that males are involved in approximately 50% of all cases of infertility and repeated miscarriage, and yet very little is done to explore these issues further.  Many couples are now being offered IVF/ICSI with very little in the way of tests that might help them to understand what these might be, and allow them to conceive naturally.  Interestingly, IVF/ICSI success rates have not increased since the birth of the first IVF baby, Louise Brown over thirty years ago and remain at a staggeringly low 25%.  Many couples believe that IVF/ICSI is the panacea for their fertility difficulties and that they will end up with a baby at the end of their treatment.  However, if you look at the live birth rates for most fertility clinics you will find that they are incredibly low and many quote their statistics for 25-29 year olds in their advertising, as this is likely to be the most fertile group with the highest success rates.

ReproflexologyTM and Success Rates

ReproflexologyTM provides a structured and prescriptive approach to fertility issues using medical testing to support evidence of its outcomes alongside the majority of couples having a baby at the end of their treatment.  In a recent study carried out by the Association of Reproductive Reflexologists, 68% of clients conceived whilst having reflexology, using these prescriptive treatment protocols. The study looked at 180 clients, of whom 122 conceived whilst receiving reflexology, 100 conceived naturally, and a further 22 were being supported during IVF. 

Client Information

When treating couples it is important to ensure that we see both of them for initial consultation as without this, one will only have half of the information needed to make an informed basis for treatment.  Some of the most important things to consider are their age, weight and height, what forms of contraception they have used, previous gynaecological history, any current or previous urinary tract or sexually transmitted infections. We know that all of these can have an effect upon fertility and the smallest anomaly can be the key to a solution.

Additionally, many prescribed medications, can have a detrimental affect upon fertility and pregnancy, so making a note of these and researching any effects upon fertility for both men and women will be an important part of building a picture of what might be causing a problem.  We cannot suggest that our clients stop taking any medication, however, we can suggest that they see their medical practitioners for further advice.

Detailed information on any forms of assisted conception they have undertaken with their current or previous partner, which for IVF should include the number of cycles undertaken, and results for each cycle i.e. number of eggs harvested, number fertilised, grades of the embryos, how many were replaced and how many were frozen. This allows practitioners to identify patterns within treatment and also monitor the effects of reproductive reflexology during treatment.

Alcohol, smoking and drugs all have an affect on fertility for both men and women and there is much research to support this.  

The current guidelines issued by The Royal College of Obstetricians and Gynaecologists states no alcohol for women in the first 12 weeks of pregnancy, as they believe there is no safe limit for alcohol consumption at this time.  As it is difficult to predict when conception will take place, it makes sense to recommend abstinence whilst trying to conceive. 

For men, it is suggested that 4 units (not glasses!) of good quality (preferably organic) red wine a week would be acceptable, but not beer or spirits as both can be responsible for elevated levels of free radicals which can cause damage to sperm DNA, morphology and motility. 

Both smoking and drugs should be avoided due to their high levels of toxicity and in the case of drugs, the addition of unknown toxic substances.  If clients are struggling with this then it would make sense to refer them on for additional support for addictions.

Medical Testing

Current NICE guidelines for couples trying to conceive, suggest that if they have been trying to conceive for over 12 months (6 months if they are over 35) they can ask their GP for a basic semen analysis for the male and a basic hormone profile for the female.  This provides invaluable information for practitioners not only in terms of what might be affecting a client’s fertility, but as a measure of the efficacy of reproductive reflexology.

A basic semen analysis will look at volume of seminal fluid, count in millions per ml of sperm, motility (how well they are moving) and morphology (formation).  This provides us with some idea of male fertility and can also be repeated once they have been treated for 8 -12 weeks so assess their progress.

For women the main hormones for testing would be FSH (Follicle Stimulating Hormone), LH (Luteinising Hormone), Oestradiol (Oestrogen), Prolactin and Thyroid Function Tests (TSH, T3 and T4).  These tests should all be taken on days 1-3 of the menstrual cycle for the most accurate results (other than the Thyroid Function tests, which can be taken at any time) and provide information on ovarian reserve and functionality of the menstrual cycle.  Progesterone should also be tested at 7 days post-ovulation to provide evidence of ovulation taking place and the levels of progesterone being produced to support implantation and pregnancy.

Basal Body Temperature Charting

Charting the menstrual cycle by taking the Basal Body Temperature at the same time each day is an excellent way of looking at the cycle in detail and also monitoring for improvements whilst using reflexology, please see the female case study included with this article.

For accuracy, the temperature needs to be taken orally (under the tongue) at the same time each day on waking, and before getting out of bed, eating drinking or speaking.  This provides the BBT at its lowest and most accurately measurable level, and means that a chart can be plotted to show the temperatures during the follicular and luteal phases of the menstrual cycle. It should show a lower temperature during the follicular phase, a dip at ovulation and temperatures at a higher level post-ovulation (when progesterone is being produced).  

This means that we can accurately measure when ovulation is taking place, whether the right cervical mucous is being produced at the right time and whether the temperature (and therefore progesterone) is remaining high enough for long enough in the luteal phase of the cycle.  It also means that if there are issues with ovulation or progesterone we use the ReproflexologyTM protocols to remedy these issues, then we can monitor their progress using the charts provided by clients.  It is an invaluable tool.

Considerations When Working with Reproductive Couples

• How do you feel about working with couples discussing, what at times, will be intimate details of the their private lives.
• Keep safe – if working with a member of the opposite sex make sure that you are not on your own and there is someone else in the building, certainly until you feel have built a mutually respective working relationship with them.
• Be forensic in your approach to gathering information, sometimes it is the smallest thing that can make all the difference.
• Ensure that your clients feel safe and respected at all times.  And ensure confidentiality both during their treatment sessions and with any medical notes.
• If your clients have been told to stop treatment or are asked not to have treatment by their fertility clinic you must abide by this.  Your insurance will be invalidated if you don’t.
• When working with clients using assisted conception, make sure that you have a copy of their drug and treatment protocol. You will need to know what drugs they are taking, at what dosage and when they are taking them.
• When working alongside assisted conception you are using reflexology to promote the efficacy of the drugs that being taken.
• Always consider the emotional, physical, mental and practical affects of treatment upon your clients.

Female Case Study

Consultation

Nia had been trying to conceive for 18mths without success and had been diagnosed with Poly Cystic Ovarian Syndrome and had a very irregular menstrual cycle, with no clear pattern of ovulation, and progesterone deficiency.  She had been referred for treatment to her local fertility clinic and was awaiting an appointment.  

Treatment

We asked her to begin basal body temperature charting immediately and began treating her on a weekly basis.  The weekly protocols aim to support each stage of the menstrual cycle, working during the bleed, the follicular and luteal phases to ensure that each stage was functioning as it should.

Using temp charting to monitor progress we could see that ovulation occurred more regularly, the luteal phase lengthened and progesterone levels rose.

Eight months later she was pregnant and after a straightforward and healthy pregnancy, gave birth to a little girl.

Relevant Reflex Points

Hypothalamus, Pituitary, Thyroid, Ovaries, Uterus, Fallopian Tubes, Pelvic Lymph Nodes. These points are stimulated, balanced or manipulated according to whether a client is in the follicular or luteal phases of the menstrual cycle. Or sedated during the bleed.

Male Case Study

Consultation

Peter presented with a highly abnormal Semen Analysis result and elevated levels of Sperm DNA fragmentation.  He and his wife had been trying to conceive for over 2 years and had a history of repeated miscarriage related to the elevated Sperm DNA fragmentation. He was referred for further testing to an Andrologist to ensure that we had current results, these confirmed his history. 

Treatment and Reflex Points

Treatment was weekly for 12 weeks using a protocol that focused on the following reflex points:

Hypothalamus, Pituitary, Testes, Prostate, Vas deferens, Pelvic Lymph Nodes.  And additionally reflex points to reduce stress levels.

These points are stimulated to encourage the production of greater quantities of sperm. Some of the reflex points are worked in combination to improve hormone communication between the relevant organs.

Result

Repeat Semen Analysis showed improved numbers of sperm, increased sperm morphology and motility.  The levels of Sperm DNA fragmentation had improved. 

Six months later this couple fell pregnant and delivered a healthy baby boy.

References:

Enzer, S, The Maternity Reflexology Manual, self-published, 2004
 

Barnes, B/Bradley S G, Planning for a Healthy Baby, Ebury Press, 1990

Barnes, B, Male Infertility – Fighting Back, Foresight, 2003

Fisch MD, H, The Male Biological Clock, Free Press, 2005

Lewis PhD, R, The Infertility Cure, Little Brown, 2005

Guillebaud, J, Your Questions Answered – Contraception, Churchill 

Livingstone, 2005

Domar, A D PhD, Conquering Infertility, Viking, 2002 

West, Z, Guide to Getting Pregnant, Harper Thorsons, 2005

Glenville PhD, M, The Nutritional Health Handbook for Women, Piatkus, 2001 

Greer Prof, I, Fertility and Conception, Collins, 2007 http://www.sciencedirect.com/science/article/pii/0378427484900900 www.organicconsumers.org/scientific/growth-hormones-fed-beef-cattle- damage-human-health http://www.whattoexpect.com/preconception/fertilityfoods.aspx
Jensen TK1, Swan SH, Skakkebaek NE, Rasmussen S, Jørgensen N, 

Caffeine intake and semen quality in a population of 2,554 young Danish men, Am J Epidemiol. 2010 Apr 15;171(8):883-91. doi: 10.1093/aje/ kwq007. Epub 2010 Mar 25 

http://www.nhs.uk/news/2014/10October/Pages/Moderate-regular- drinking-may-still-damage-sperm.aspx http://www.nhs.uk/news/2011/12December/Pages/wifi-laptop-signals- sperm-fertility-damage.aspx 

http://www.sciencemediacentre.org/wp-content/uploads/2012/12/Sharpe12-EMBO-Reports.pdf

http://andrologysociety.org/getattachment/2d3132da-b376-43e0-80e5-1ba52c158936/chapter-26.aspx

The greater majority of men have little idea of how their reproductive system functions and even what the component parts may be.  I was reading an article just today that in a survey carried out by the charity Prostate Cancer UK of 1,900 men, 17% did not know that they had a prostate, 54% did not know where it was and 92% (yes 92%!) had no idea of its functions and responsibilities.  

I would also like to say that it is not just men who are ignorant of how their reproductive systems work, most women who come to see us as practitioners are equally badly informed.  And this lack of information lies in the fact that we are not educating our young people well enough about their fertility and reproductive systems. 

So, to return to the issue of what is the prostate.  It plays a key role in male reproductive health and also that of the urinary tract.  It is a small gland approximately the size of a walnut, and works like a valve either allowing urine or seminal fluid to pass through the urethra.  It is also responsible for producing 90% of the seminal fluid that supports and nourishes sperm.

It is one of the key issues when addressing issues with male fertility, as an enlarged or diseased prostate will cause damage to sperm.  

Making sure that your sperm are well-formed, swimming well and that there are plenty of them will make it easier for you to conceive naturally. 

Reflexology is an excellent form of treatment for supporting not only the prostate, but the other component parts of the male reproductive system, including the testes, epididymis and vas deferens.  And can be used to improve the quality and quantity of sperm produced.

There is also much that can be done by making a few alterations to diet and lifestyle that will improve sperm production, motility (ability to swim) and morphology (formation).  Research has shown that the following recommendations can make a real difference in improving male fertility and we certainly encourage our male clients to try and incorporate them.

• Reduce alcohol to no more than 4 units a week, not beer, preferably red wine.
• Eliminate Caffeine.  Remember this is in tea, coffee, chocolate, fizzy drinks.
• Increase vegetable and fruit intake to 5 portions a day, preferably organic.
• Reduce intake of red meat, increase intake of fish and poultry, again organic where possible.
• Wear loose fitting trousers and underpants to keep the testicles cool.  They should be 2 degrees cooler than body temperature.  Sperm don’t like heat, it can cause morphology issues.
• No intensive muscle building exercise, as testosterone can be diverted to muscle building rather than sperm production, and you could end up with a lowered count.
• Absolutely no smoking or drug taking!  I am afraid both of these have a very damaging effect upon sperm.

Remember….

This is not forever, it is just whilst you are trying to conceive.

All that you ingest or are exposed to can effect not only the sperm production and formation, but also the DNA.  Poor sperm DNA can lead to conception difficulties and repeated miscarriage.

ENDOMETRIOSIS

A condition in which endometrial tissue grows outside the uterine cavity, endometriosis can develop in the pelvis, around the bowel, or in the bladder, ovaries, vagina, and, in extreme circumstances, the lungs and the brain. It is thought that as many as 20 to 25 per cent of women in the UK who are subfertile have endometriosis and approximately five to ten per cent of all women of reproductive age.

Diagnosis can take anything up to eight years, making it hard to be certain exactly how many women suffer from the condition. The main cause is thought to be retrograde menstruation, when instead of passing out of the vagina, the endometrial tissue passes through the Fallopian tubes and into the abdominal cavity. Women whose mother, grandmothers or sisters have the condition are at increased risk, as well as those who have had a hysterectomy.

REPROFLEXOLOGY TREATMENT FOR ENDOMETRIOSIS

The most effective time to treat endometriosis is during the bleed, when the lesions will be most active and so treatment can clear stagnation and debris in the system. It is also the most useful time to manage any associated pain.

What to feel

Reflex points of affected organs will feel like soft extended lesions around the reflex points. These organs are most likely to be the ovaries, uterus, Fallopian tubes, bladder and rectum. The reflex points themselves can feel spongy and indistinct; the lesions can range in size from very small pockets to large extended affected areas.

Treatment protocol

Use the following protocols during the bleed and as part of each weekly treatment, followed by the relevant weekly treatment.

• Endocrine sedation

• Reproductive sedation

• Uterus sedation

• Fallopian tube sweep

• Pelvic hold

• Solar plexus

• Sedation of any other affected areas: bladder, vagina, rectum, and so on.

ADENOMYOSIS (ANDOMETRIOSIS)

Adenomyosis is distinct from endometriosis in that additional endometrial tissue grows within the muscular layer of the endometrium, causing an  enlarged uterus, pain, and heavy bleeding. It can be diagnosed at the same time as endometriosis.

REPROFLEXOLOGY TREATMENT FOR ANDOMETRIOSIS

The treatment plan is the same as for endometriosis, but focusing on the uterus reflex point.

What to feel

Uterus reflex points feel extended, enlarged, soft and spongy. The edges of the uterus reflex points can feel blurred or indistinct.

FOCUS ON… SYMPTOMS OF ENDOMETRIOSIS

Symptoms will vary from woman to woman, depending upon where the endometrial deposits are and the organs that the condition affects. The most common symptoms are:

• Pain on intercourse

• Painful, heavy or irregular bleeds

• Bleeding between periods (inter-menstrual bleeding)

• Painful defecation

• Rectal bleeding

• Chronic pelvic pain

• Abdominal pain

• Fatigue