[00:00:00]Hey there friends, and welcome to lunchtime Live with the center where we talk about fertility topics and answer your questions as well. My name is Ami Chokshi and October, which is right around the corner, is acupuncture month. So today we’re talking to Helen, BetGivargis, who is a licensed acupuncturist and specializes in fertility as well.

[00:00:21] She’s been doing this for about 13 years, and before that, Helen was also an embryologist at the center, so she is a well-loved family member here. Hello, Helen. How are you?

[00:00:32] Hi. Thank you Ami for inviting me and thank you, the center. You’re welcome. Yes. I feel like I’ve been family for a long, long time, since 1984,

[00:00:43] Oh, that’s amazing. That’s great. Now before we get started, Helen will also be taking your questions, so please do comment if you have any. So Helen, Many women are who are dealing with fertility issues turn to acupuncture. Can you talk a little bit about what acupuncture is and how it impacts fertility?

[00:01:02] Sure, sure. More and more people are hearing about acupuncture. It’s becoming more of a common name and world of holistic health, but particularly fertility. Acupuncture really became, entered us in a more legal. In sixties and seventies. Until then, it wasn’t known and it was then more known for pain.

[00:01:24] But it is a whole system medicine and I have to speak that language a lot because I often assist teaching it medical students. So it’s a system of medicine into itself. It’s over, , 2000 years old, like some think over fi, about 5,000 years in practice. The actual written medical book is 2000 years old and that’s this book we studied.

[00:01:47] So, fast forward to about past 20, 25 years, a lot of attention, a lot of studies are have been from Western medicine for all aspects of that Chinese medicine haven’t used. But first I have to say, acupuncture is part of the whole system. Medicine called. Traditional Chinese medicine, medicine or TCM or traditional Eastern medicine and acupuncture is one aspect of it.

[00:02:13] We take this and we sort of study it and let of studies. So just keep that in mind. That’s when I treat clinically, I still look, , I have to do a constitutional check, like, ask questions based on Chinese medicine and implementing treatment. That’s always with acupuncture. What do you eat? How does your life what lifestyle stressors are involved?

[00:02:34] There’s so much more guidelines in terms of breath work and so much more. About the first, I, I focus a lot on the studies because I was a researcher when I started in endocrine fertility before I became an embryo. And I post studies that really show beautiful results. . That’s what we want. We want results.

[00:02:52] Everything we do and the one that really stands out that shows how acupuncture works better is Dr. St. Studies in 1998 or 1999, and she did it on a group of women who were not ovulating and it induced ovulation. It brought on periods women who weren’t having period for months or eight months or so forth.

[00:03:11] So that sparked a lot of interest, like what is it doing? So we know it works. It regulates menstrual cycle. It reduces Hyperandrogenism. Androgen. Yes. And, and it does something that hormones obviously. So then another study she did with IVF patients, and it showed particularly women with P C O S that shows their pregnancy rates were higher doing a series of treatment.

[00:03:36] She did it more clinically, like the way we do in clinic. Eight to 12 treatments, either weekly or two treatments a week. Then the other study that really sparked interest in IVF and fertility was the policy study in Germany in 2002, where they did a treatment just before and just after embryo transfer.

[00:03:53] And with that back then, now you have to realize the pregnancy rating clinics were about 23%. What are they now? It’s like way. Art clinic is very high, right? Is about 50, 60%. And the group that did pre and post embryo transfer acupuncture treatment, their pregnancy rate went up to 43%. So that brought a lot of attention.

[00:04:15] That was like just that one treatment. What does it do? How did it work? So again, most studies are done and most of them show these same results. But then about a decade ago, Dr. Elli, who’s the objective endocrinologist in Colorado with another group of acupuncturists, Diane nda, they did put these together like, well, clinically, this is how it’s done.

[00:04:38] We do a series of treatment pre and post and some treatment to support and let’s see how that does with a bigger group of patients. And it showed that this whole system medicine, improves again, pregnancy rate, but reduced miscarriage. Which is early miscarriage rate or biochemical pregnancies were less in the group with acupuncture.

[00:04:57] Hmm. Which is very interesting. But he also measured hormonal levels. Blood in the blood in women who had acupuncture and women who didn’t. And there were some differences. Very my but enough to re, in terms our research to pay attention. So we know cortisol and prolactin is different in women who get acupuncture.

[00:05:18] And then last. My favorite and my colleague Dr. Lee Holland. Ruben in uc, San Francisco. She’s been working with this and doing studies in P C O S, women’s health hormones and IVF particularly. And again, she, because we mostly do a whole system medicine, that that does better than, pregnancy rates.

[00:05:40] Were higher in the group that they just preimposed mm-hmm. than the group. Did not do. And then, so she did three groups, which is a really good study. And then a group that did a whole system, which means a few treatments, at least before or during the stimulation cycle. And then the pre post, then a couple to support it, and that pregnancy rates were 61.3% versus the group that just did pre and post.

[00:06:07] That was a year ago, which was 48%. So putting all those studies together, it. Again, most of the study shows that pregnancy rates are higher using acupuncture as another tool to support you. Oh, that’s, that’s amazing. So can you talk a little bit about. What, what happens in a, in a treatment? Sure. So there’s always a first consult, initial consult, like every other therapeutic setting.

[00:06:35] And with that I get do an intake and learn more about what is your whole body is all together because Chinese medicine, is about balancing and harmonizing the, all the systems in the. versus often western medicine focuses hone in on just like the, the hormones or the, if the knee, something is wrong.

[00:06:57] So this is the whole system. You wanna bring it in balance because, just that, that’s the core of the system. It’s not, I’m not fixing the uterus, I’m bringing all the system in a state of balance. . It’s like, . So then I do a treatment after the intake. . Which needles are put often Viv below knee on for fertility.

[00:07:18] Even though I usually use less treatment, that styles of, I’ve trained mini styles, but like Kiko motor, which is Japanese style or five element, which is very gentle, but with, first of all, there’s more needles than less. The needles are hair thin. They’re like, and I would call them antennas that they.

[00:07:36] fine tune your whole system. . And it’s based on that there is pathways of energy along the body, just like your vascular system and your endocrin, your lymphatic system that these pathways we cannot see with the bare eye. That’s the philosophy of it. So I can’t prove that scientifically, of course, but that acupuncture is put along these, meridians to fine tune, the system that are mirror.

[00:08:03] Deeper levels, like the, like the whole liver system is, has its own, the, the kidney system and fertility has its own, the lung, large intestine, the stomach, spleen, the lungs. But all of this have to be harmonized. So when I check the pulse, look at the tongue, and sometimes the abdominal pa patient, and from the questions.

[00:08:23] Then I’m like, , are we talking from Chinese medicine diagnosis? I put something together and based on that, I treat you. So you may be treated different than another woman who comes with both same western medicine diagnosis of like, let’s say poor ovarian reserve. So then you lay on a, in a, with a suiting music, I often use other aspect of Chinese medicine.

[00:08:47] Guide you through a meditation or a microcosmic breath work, which is a really nice chi breath work, and then leave the room and let you rest. Then some, some of us call it let you cook. And then often people, relax even in the first treatment. By second treatment people fall asleep. And then that’s the first treatment.

[00:09:08] And then follow up treatments are similar, a little bit shorter. The first treatments a little bit longer of. Treatments. treatments are accumulative and that’s definitely from Dr. St. Studies show that after a series of treatment, like the cycles harmonized, however, I have seen, and I’ve come to this conclusion after like years of being.

[00:09:29] Sometimes we are just a little bit out of tune. Sometimes maybe we are a lot out of tune. Sometimes we maybe need that vacation and we go and we come back and we get pregnant. Sometimes we need that couple of treatments of acupuncture. Sometimes we need to leave our job. Who knows? It’s like that. I feel like acupuncture works like that too often.

[00:09:50] Yes, series of treatment will help, but sometimes even little bit may normalize what was out of balance. now is acupuncture. Good for any diagnosis in with regards to fertility. again, acupuncture. It goes by Eastern medicine diagnosis. But from, If I have to translate it as a scientist to western medicine, Yes.

[00:10:14] Again, we’re bringing the body into a state of balance. Often we find women with unexplained fertility, with poor ovarian reserve, with poor responders do really on P C O S do really much better than younger women. Using acupuncture. That’s not to say younger women shouldn’t be using it, but I’m saying particularly if there’s issues, and with unexplained is like, we don’t know what it is.

[00:10:37] Everything looks good. . And that’s, that’s why, same with like, if I had to like chronic issues, work really good with acupuncture and Chinese medicine, because there’s systems that we don’t know. . Yes. And you see that we have a question regarding specifically unexplained infertility. And if there is, , is how is acupuncture helpful for women going through IVF with unexplained infertility?

[00:11:02] Again, I go to the core root of Chinese medicine, which is we are bringing your body to a better state of homeostasis or balance. Homeostasis is a very scientific term actually, and balance is a, I know it’s a cliche often, but that’s what the core of Chinese medicine. It’s like that. It’s like that you wake up in the morning and , something is off. You’re not sick, you’re well, but you’re, he isn’t quite there. You’re like, Oh, today I really should drink more water. . Or maybe today I should take the day off and just go outside in nature. So what you’re doing, , your body’s a little bit off and you’re doing something that you think will support you, or let me Today, I, , past few days I’ve been eating really unhealthy.

[00:11:47] Let me, today, I make sure I’m eating. Well and feel better, or I need better, a little bit more sleep next few days I’ll make sure I sleep well. Right. So again, innately we know when our body’s out of balance, but Chinese medicine does it stronger than I off. . Stronger. It’s like a stronger medicine in terms of these needles are put in.

[00:12:08] It works through the central nervous system. That’s how we are finding out more. It, it normalizes the HPA axis which is hypothalamus pituitary ovarian access and HPA access. Hypothalamus Pituitary adrenal axis. . And we know that it normalizes cortisol, so that plays a lot of roles in all the cascade of hormones as well.

[00:12:33] I hope that answers. .

[00:12:34] I think that’s, that’s great. So now you said they’re really thin needles, so is there any pain involved? people ask that often. They are hair thin. Like if you look at your hair and it’s like it’s that thin, often you can’t see them.

[00:12:49] I particularly use a gentler needles in gentler treatment called based on japanese style of acupuncture, so they’re much thinner and you may feel a little mosquito vibe sometimes. Most of them you actually don’t feel this is fascinating. Sometimes you may feel a little pinch and if it should go away, it goes away as soon as you’re putting it in. ? And it’s barely goes on your skin.

[00:13:14] I’m tapping it as. Very tiny, unless I’m doing, working on sports like injuries, the, and then muscle, bigger muscles of like, let’s say hips. Then I’ll use, , longer insertion. But otherwise they’re pretty shallow. Once they’re in your, really go in a state of, of relax. I rarely see someone. Doesn’t like it.

[00:13:38] And if that’s the case, I always say, , and, and they’re like, No, but it’s good for us. I’m like, Don’t do it if it’s you don’t do it. But it’s like in the 15 years of let’s say 16 years together, I’ve been treating patients, maybe one patient. And that’s, I encourage them like, Go get a massage. It’s , You’re two tens for this.

[00:13:58] It’s , but it’s. . It’s so calming. I have to say. I’ve had it done and, and I just think it’s just so relaxing and calming and, when you’re in a state of constant, in a regular state of stress, if you’re dealing with fertility issues and you’re feeling anxious, it is so calming and it just makes you take a break and take a minute to relax as well.

[00:14:19] and that’s another piece that often we used to say, Oh, acupuncture, maybe’s, just relaxing. It does. It does. And I believe that’s why, because I’ve been thinking as a scientist, why is it pre post, even just that showing good results. Whereas, , it usually takes a little bit. It’s like me telling you, you have a marathon tomorrow, have a good breakfast in the morning, and you’re, and you’re like, Well, should I eat good breakfast every day?

[00:14:44] I’m like, , sure. For, prepare for a good month for it, and sleep well, but. I almost lost the state of my, this train of my thought. Let me, You were just talking about being relaxing. they’re relaxing. So the pre and post, I believe. , because haven’t been in an embryo since 1984. And when we would be, , bringing the embryo back to that day, women get so stressed out.

[00:15:10] Mm-hmm. And good reason as the more, as more I sat with, it’s like, it’s a day that finally the embryos put back. It’s a lot of weight on a woman. On a woman who’s like, , now it’s all on me. Until now, we’re like working together. Sperm and egg are together. If, if anything still there’s. going through, and then suddenly the embryo’s gonna be put back.

[00:15:30] So it’s a, a lot that day. So anything you can do to, , calm your nervous system, it’s good. But we are also, finding that there’s a study that showed it calms the uterine uterus gets. with on the gets contractions. . So it really reduces uterine contractions. I see the pre and the post treatment, and it also brings more blood flow.

[00:15:54] The urine artery ility increases, so there’s more blood flowing. The uterine lining increases because of that. And that’s where, let’s say, just transfer we’re talking about. But definitely relaxation is a big piece of it to. . You, you, you’re talking, you, you mentioned that it’s, , it’s great for the women for pre and post transfer.

[00:16:16] Do you ever see men with regards to this as well? Do, can, can it be helpful for men as well? . . There’s many studies support that improve motility improves. The ility improves a, a lot and the volume with acupuncture, and there’s many, many. Overall, men tend to not, seek acupuncture for their fertility.

[00:16:39] That’s interesting. But often I see first there, , the partner comes and gets some treatment. Then slowly she brings her husband if he has issues. But sometimes even if they don’t, she brings him to just, , again, to optimizing his health because at the end it takes. , it really takes two. And, I attend often the, almost every year, the integrated fertile Symposium in Vancouver.

[00:17:04] And many speakers come. And the last few years there have been a lot of emphasis that we forget about sperm because we’re doing, it’s like, , we’re just gonna be injecting it. It’s like, no, you still want a highly. , healthy sperm to go into your egg because then you’ll have a very optimized, healthy baby.

[00:17:23] Even it’s being tested. Your, the men shouldn’t be off the hook. . . Now, you had talked a little bit about series of treatments. So, , how often, when should it be done? , what are, is there, is there a good number to start with? Is there. How does that work? . Again, I will say, first I meet you where you are.

[00:17:46] . . Time consuming and it involves more than that. So, even like even getting one or two treatments, is it better than not getting any treatment? Having said that, as soon as , you are doing work for fertility, you’re at the center. Are incorporating other things like, Oh, I should eat healthier.

[00:18:05] Let me see what’s supplement. Then start adding acupuncture. Get the first treatment. At least get the initial consult. So you are on the road. ? What things to look for, what things to do. You have some tools and you get a treatment. Do I like it or not? Maybe I, it’s not for me. or am I compatible with my practitioner?

[00:18:24] That’s another important piece. Like we are working well together. And then , I always give a treatment plan and then you decide, do I wanna come? Like if the IVF is in six months, I’ll get a few treatments. And then as it gets closer, ideally you wanna, I actually looked at a study yesterday from Australia that pulled all this together and it says, you wanna at least three treat.

[00:18:47] Is the minimum you should get. And if that’s pre and post, and one should be during your stimulation cycle, a study actually showed less than three. It’s, , it’s at a place that you want to get at least less three. . And then ideally more than three do does better. . And anywhere, like for P C O S, it says 16 to 18 treatments for, usually.

[00:19:13] Norm in all part clinic is a three month cycle, and often it’s called once a week to come. Some practitioners do two treatments a week. I often stay with one treatment a week, and so it’s with three cycles. We know we can change things we have because we won’t know until the next cycle begin. How, Especially if women are having, Oh, I had less cramps or I, the bleeding wasn’t as heavy or I don’t bleed.

[00:19:40] I only bleed very light. But now that the acupuncture, I’m bleeding normal, like when I was younger. So these are all signs that I know we’re in good track. We’re making slow movement. , so the basic it, so you talked about pre and post. So during stimulating the, the stimulation stimming and then right after, A transfer as well is helpful.

[00:20:04] And what about that two week wait? Is that a time to do it as well? and that’s where both Mag, Le and Ruben studies both show that, that early, what I call it tender first few weeks, that acupuncture shows it reduces. Biochemical pregnancies, it reduces early miscarriage. So, and again, the reason is because it’s bringing more blood to the area.

[00:20:31] It’s relaxing you. All of those and normalizing any fine tuning any small minute ways of balancing the system, which is the endocrine system, the hormonal system. And that’s, so that’s actually studies that showed, Mag showed along. increasing pregnancy rate. In the group of acupuncture, there was less miscarriage.

[00:20:52] . And now, and going back to how it works, are your, are your clients on their back? Are they on their stomach? I do both. Again, depending, Each treatment is based on when you come in, again, you’re constitutionally, and by by now I know what’s your constitution, what points I should always use. For example, for you.

[00:21:13] And then based on when you are where you are on your cycle, I will tailor it. Sometimes it’s like, oh, treatments are based up a lot of points on your lower abdomen. Sometimes based down, particularly the area on the, on the back of the sacrum is a very powerful place of treatments. . That I use in the mid back and back of the head.

[00:21:36] There’s some point back of the legs, but, And that’s why like, Doing just a regular, , abdominal massage or massaging your back is actually just do it. It’s a good idea. It’s like you’re bring more blood, your vi your bring more vibrancy there. Yes, yes. . So it all depends on the person. It all depends on the intake, depending on the person, the time of the cycle, where we are in, whether we are doing Id.

[00:22:04] Or ii where we are in those stages. All of those are a factor in how I’m gonna be treating you that day. . And do you, do you, is it take a certain amount of, is it a, is it an hour treatment cycle or? Treatments are about an hour. , about an hour. So I take, do an intake, then start putting the needles, guide you through.

[00:22:26] Meditation and then leave you there. Come check and then take the needles out. You have any questions? And then, you go. And is it typically covered by insurance? It’s typically not covered by insurance. Because most insurances still in state of Connecticut are not covering it. There are some that they say they cover acupuncture, Just look at.

[00:22:47] Look at between the, the small lines as they say, there may be a deductible often like for with Blue Cross, I know it says like they may look often, they don’t cover fertility, but they may cover, like, often they cover pain, ocr, arthritis, migraine knee pain, and nausea from, chemotherapy and nausea from pregnancy.

[00:23:08] So then, because I continue treatments throughout pregnancy on less intervals of. I mean longer intervals and NA is one of the things and they cover it. But in my practice, you pay a fund, I give you an A form at ICD codes, you submit it and they give whatever that they would give. One thing I wanna say in terms of, acupuncture is education that it’s three years at least long, and since I’ve.

[00:23:35] Since I graduated, there’s not a year that I don’t take courses, particularly with specializing fertility. So you wanna go to someone who ha, who’s licensed. There are a lot of, , well meaning chiropractors, natural paths and that do acupuncture. But most often they just study at 300 hour course online.

[00:23:55] And they don’t know the. System medicine, it’s a very intense, broad system, particularly for fertility. You wanna see someone who’s at least have studied, , have , their licensed economic. I know that you take a lot of coursework, classes of coursework and are well entrenched in the world of fertility and acupuncture.

[00:24:17] And, and also again, that’s not to say those acupuncture treatment aren’t good. It. You want a complete system of treatment for what you’re doing particularly. And the other thing is there are, there’s a whole movement in physical therapy that are using, needles as a, but they shouldn’t be calling it acupuncture.

[00:24:37] They’re just doing it for muscle release. And that’s, there, like in terms of safety, we’re having some problem with physical therapists. So, that’s one thing you don’t wanna use for fertil. That. . The licensed practitioner is what you should be looking for at least. . Now we do have, we have a couple of questions.

[00:24:55] One of ’em is, Meg says that she doesn’t live in Connecticut anymore. Do of any practitioners in the Philadelphia, Delaware area I know, , know a lot of people, especially in the Northeast? . And what I would say, I actually don’t know many in Philadelphia, but I can look in the circle of.

[00:25:12] My fertility expert to see who they are in Philadelphia. If you email me, I can send you information. One of the things you wanna look for is that they do fertility treatment, that they’re also aware of the Western medicine, aspect of it. They’re, they’re well versed because it’s important to be able to talk about it, and know that whole world, that whole concept.

[00:25:37] Often you wanna look a B is one. Like there’s a licensing for fertil, the specialists that later they made it in all the courses that we took, then they created. Abom is like a specialty website where there’s a list of practitioners that might have that specialty that they can, that make it look. If you look at a B A B O R M, .

[00:26:01] Thing we’ve put together along, , my teachers, I, , I was an embryo just so I don’t need to do that, that route. But and I would, I would ask if you can email me as well, me, if I find more, I will, I will give you more information. But if you look under, Aorm, you’ll find more fertil of the experts under that.

[00:26:22] . What is your email? It’s Helen at acupuncture tree of life.com. Just like my website is, Acupuncture Tree of Life. Then Helen at acupuncture. Perfect. Another question, Is this done at the center? And I can, I, I can answer part, I can say that yes, for pre and post transfer it can be done at the center, but Helen, .

[00:26:42] You’re also so close by as well. . . The center, once they put it together, they moved and, and we worked together where when patients request that, I come there at like two minutes not even from the center. So most patients actually come to my office because it’s very relaxing. There’s a nice music, and they get into that mode.

[00:27:04] And some patients, particularly those who travel, and they’re coming from far, they come there and they’re like, can I get the treatment? Then we plan it ahead and I meet them there, do their treatment, and then wait until the transfer’s done just really often fast, , and then I do treat them right after and they don’t have to change or anything.

[00:27:24] And then, Oh, great. , so another question. If insurance does not cover acupuncture, about what is the price range for each session? Sure. The basic initial consult is one 40 and follow up appointments are a hundred. . So that, that’s the basic of the fertility and you other works that I do when I bring, there’s other factors, but, that’s the basic, that’s how I treat and most of my patients are fertility.

[00:27:49] So that’s what it’s, Do you accept, do you take HSA accounts, those type of health spending accounts? . . You always think that. No problem. It’s, And sometimes do, sometimes you offer like a I forget what they’re called, a super bell for patients. I always give them. . , great. So Tara says, I find it very calming and relaxing and I feel it was a big part of us having a successful transfer.

[00:28:14] That’s lovely. Hi, Tara. Yes. She’s a beautiful girl. Wonderful. Helen, thank you so much for sharing your wisdom today. Oh, thank you. Sure. And thank you everyone to, for being good luck everyone. May you all, have a fertile life and beautiful. Oh, wonderful. Well, we’ll be, we’ll be na back next week for another lunchtime live.

[00:28:35] And be sure to check our website, uconnfertility.com for a calendar of events, from support groups to yoga to these live informative sessions as well. So we just want to be able to help you and support you and stay connected because this can be a challenging time. So anyway, have a great day.