Q I am about to undergo IVF and have been reading a lot about the effect of diet and acupuncture on the success. I would like an opinion from you as to whether it is worth my while investing in acupuncture and whether or not I should use Chinese medicine also. A few friends of mine swear by it, but I haven't found any impartial research or opinions. It is all so confusing. I don't have a lot of money, so I don't want to waste any of it. What is your opinion?
A I understand the heavy financial, emotional and physical burden on couples embarking on IVF treatment. It is only when a situation applies to you that you realise how common it is, with one in seven couples needing assisted fertility techniques. You alluded to the need to watch your pennies, and I couldn't agree more.
While acupuncture is an almost 2,000-year-old practice that many people believe in and find helpful with ailments such as depression, stress, joint pain or fibromyalgia syndrome, it still lacks concrete data on its efficacy in assisted reproduction techniques.
A Cochrane review from 2013 concluded there is no evidence that acupuncture improves live birth or pregnancy rates.
However, some studies have shown increased rates of spontaneous and assisted conception rates in women (and their partners) who quit smoking, reduce stress levels, reduce alcohol and caffeine consumption and maintain an ideal body weight. Fertility treatment clinics will advise patients to do all of the above.
You should aim to keep to moderate weekly alcohol consumption, defined as less than four units per day or three to 13 units per week. Prior to conception and during pregnancy, complete alcohol abstinence is advised, as studies have not been conducted to establish safe limits. Women should aim to keep caffeine intake below 200mg per day, between one to two small cups of coffee per day, and watch out for other sources of caffeine such as black tea or chocolate.
Bearing in mind that there is no strong data to recommend dietary changes to enhance fertility, several large observational or prospective studies have concluded that certain dietary habits may be considered general components of a 'fertility diet.'
The focus should be on higher mono-saturated fats such as avocado, nuts and olive oil compared to artificial forms of trans-fat found in fried fast food, donuts, muffins, cakes and pastries. Also try to eat higher protein from vegetable/vegan sources rather than over-reliance on animal sources. When choosing a carbohydrate, try to opt for low-glycaemic index carbohydrates (brown bread with nuts and seeds) versus a bagel/white bread/white rice/white pasta/white potatoes). It is believed that high-fat dairy foods are better when compared to the 'low fat', often high in sugar or added sweeteners. A general suggestion is to opt for wholefoods versus processed foods. Some evidence suggests taking a multivitamin with low-dose iron supplements.
In terms of medical conditions relating to your diet, it has been proven that coeliac disease, if left undiagnosed or untreated, may cause sub-fertility both males and females. This can be easily reversed with a gluten-free diet.
Lastly, over-exercising can adversely affect fertility. Therefore female patients with a normal BMI (18.5-25) are advised to limit vigorous exercise such as running, fast cycling, aerobics, swimming or gymnastics to four hours per week.
⬤ Dr Grant is a GP with the Beacon HealthCheck screening progamme at the Beacon Hospital
Health & Living