Kim Fama, senior marketing analyst at SAS, is at full term in her pregnancy. Lying on her left side, she relaxes on a table in the cozy, serene exam room at the Duke Fertility Center on Fayetteville Roada in Durham.
Fama remains relaxed as Katherine Rowe, a licensed acupuncturist, inserts a tiny, cat whisker-thin needle into a point on Kim's arm.
Rowe adjusts the needle to the correct depth, then carefully takes another individually packaged needle and taps it into a point on Kim's opposite arm. After the needles are symmetrically aligned into points on her arms, feet, ears and head, Kim begins to enter a state of relaxation for her 30-minute acupuncture session.
In March, the Duke Fertility Center introduced a new in-house acupuncture program for patients undergoing fertility treatment.
"We began to place a greater emphasis on how stressful it is for patients to go through fertility treatments," said Julia Woodward, Ph.D., director of the psychological services program at the Duke Fertility Center. "We had patients who were seeking complementary medicine services outside of our program and we recognized that going through fertility treatments is financially expensive and impacts all aspects of a patient's life."
Woodward said rather than just treating the patient's reproductive system, the Duke center wanted to move towards treating the patient as a whole.
A Second Child
While living in San Francisco with her husband Rob, Kim became pregnant with their daughter Lauren, now three years old, within only two months of the couple first trying. After a cross-country move and career changes, the Famas decided to have a second child. After trying for a year without success, they learned they had fertility complications.
"We had a lot of change going on in our lives at that time, with our move and building a house, and we think that might have influenced things," Rob said.
"We just thought it was stress related," Kim said. "Then we had tests run and even after seeing the data, we didn't believe it."
After exhausting all their other options and enduring an unsuccessful round of fertility treatments at UNC Health Care, Kim and Rob found a new option at Duke. The couple began receiving acupuncture.
"I started acupuncture a couple of months before my first fertility treatment to gain balance in my mind and body prior to the hormone therapy," Kim said. "For me it helped balance everything, because hormone therapy takes a toll on your body."
Rob, a diabetes specialist with a San Diego-based based biopharmaceutical company, also received acupuncture treatments as emotional support to his wife as well as for his own relaxation.
"I was skeptical at first," he said. "I like to see clinical evidence that something works. Acupuncture seemed more on the holistic side, but I wanted to do it for Kim."
After having the treatments, Rob felt "relaxed, calmer, and more serene."
"Patients who have acupuncture treatments are likely to both feel better and cope better with fertility treatments," Woodward said. "Our emphasis is to help people trigger natural relaxation responses, and to take time out of their busy schedules to focus on self care."
Patients can prepare for fertility treatments both physically and mentally by engaging in eight to 10 appointments prior to a treatment cycle. Patients can also choose to undergo acupuncture immediately before and after an embryo transfer.
Kim learned about acupuncture's benefits for fertility through her own research, and found Duke to be the only place in the Triangle that offered acupuncture on-site and in conjunction with fertility treatments.
The Famas said they would recommend this option to other couples with similar situations. They added that couples would likely find other tangible benefits outside becoming pregnant.
Kim said, "I found the acupuncture helpful with the side effects of being pregnant, including nausea and tiredness."
In preparation for the new program the Duke center has been offering acupuncture treatments to staff, so that they understand what they are recommending to patients. Woodward received a treatment and said, "I found it to be very relaxing and completely pain free."
The Next Step
While it is known that acupuncture improves how patients cope while going through fertility treatments, acupuncture is also being researched as a means for improving pregnancy outcomes.
"We are interested in researching the long-term potential fertility benefits of acupuncture," Woodward said.
A study published in the February 2008 British Medical Journal reported that acupuncture increased the odds of pregnancy by 65 percent among women undergoing in vitro fertilization.
"The recent study left unanswered the mechanism by which acupuncture was successful," said TJ Gan, M.D., anesthesiologist at Duke.
Gan is interested in researching which acupuncture points are particularly effective in increasing the rate of pregnancy and the mechanism involved.
"We want to know why pregnancy rates are improving," he said. "Is it because the acupuncture is increasing specific hormones or reducing their stress levels or something else?"
Meanwhile the Duke Fertility program continues to benefit couples.
The outcome of all of this became clear in late March, when the Famas had their baby boy: Jackson Danford Fama was born at Duke on March 20 at 11:11 p.m., weighing 6 pounds, 10 ounces. Rob reported that mother and son were relaxed and doing well.