Positive Health Online

Infertility, sub-fertility and delayed conception are increasingly common issues experienced by approximately 1 in 6 couples in the UK.  And this statistic appears to be replicated in many countries around the world. There is much anecdotal evidence to support the use of reflexology for those couples, both men and women who are having difficulties getting pregnant, but how does it work, who may benefit and how effective is it. One of the most important things that we can do as reflexologists, is to ensure that we are gathering the right information.  In building up a picture of what the issues may be for both the male and female allows us to plan treatment effectively.  And effective, prescriptive treatment is key in supporting them on their journey to parenthood.

The causal factors of fertility issues are complex and varied, but one thing of which we are certain is that they involve the male as well as the female.  Causal factors are attributable a third male, a third female and a third joint.  Male fertility is still marginalized by many medical practitioners, which means that many couples are told that IVF is the only answer to their fertility issues, when some further testing may show that natural conception is still an option.

Reproflexology^TM (Reproductive Reflexology) aims to help couples achieve conception naturally, but if this is not possible due to the complexity of their reproductive health issues, then it is used to support all forms of assisted conception. This means that it is imperative, that practitioners understand the drugs and treatment protocols that their female clients will be undertaking and that they use reflexology to support these protocols

Importance of Menstrual Cycle Regularity

One of the most important things to address in women is regulation of the menstrual cycle.  Cycle irregularities can be caused by a myriad of different conditions, but in the main will usually present as either a fluctuating follicular phase, or a shortened luteal phase. An irregular follicular phase will mean that ovulation is taking varying amounts of time to occur.  This will make it difficult for your clients to get their timing right for having sex and therefore they will find it more difficult to conceive.  If there are issues with the luteal phase, in that it is either too short or insufficient levels of progesterone are being produced, this means that both implantation and the ability to sustain a pregnancy are affected.  It can also be a factor in repeated miscarriage. As practitioners, we learn how to use temperature charting and blood chemistry testing to monitor both progesterone levels and progression of reflexology treatment.

Basal Body Temperature charting is a fantastic tool for reproductive reflexologists to use when working with female clients as it provides so much more information than just whether a client is ovulating or not.  It allows us to assess:

• The length of/and or irregularity of the menstrual cycle;
• At what stage and whether ovulation is taking place;
• Is the correct type of cervical mucous being produced at the right time. i.e. at ovulation;
• What type of ovulation signs clients are experiencing. i.e. i.e. spotting, one sided abdominal pain, breast tenderness;
• How long their Luteal Phase is;
• Are they producing sufficient progesterone for long enough;
• Are they spotting prior to their bleed starting;
• Are they having regular sex at the correct time;
• And whether reflexology is having a positive effect upon their cycle;

If clients are using blood chemistry testing to monitor progesterone levels, then it is essential that the test is taken seven days post-ovulation, for the most accurate result.  It is very often called the day 21 blood test, as many medical practitioners assume that all women have a 28 day cycle and will ovulate on day 14.  However, many women have very stable cycles that are of a completely different length to this and will therefore NOT ovulate on day 14 of their menstrual cycle.   The Luteal Phase of the cycle is usually constant and will be individual to each woman, but will be somewhere between 12 and 16 days (this is where temperature charting is helpful).

So to provide some examples below:

Length of MC             Length of LP                 Ovulation       Optimum Prog. Test

35 days                        12 days                        Day 23            Day 30

21 days                        12 days                        Day 9              Day 15

30 days                        14 days                        Day 16            Day 23

40 days                        16 days                        Day 24            Day 31

MC=Menstrual Cycle   LP=Luteal Phase

If progesterone blood chemistry tests were taken on day 21 for the above clients, they may either not have ovulated quite yet, or would have ovulated quite some while previously, in any event the results would be inaccurate and they may be led to believe they were not ovulating at all. However, a test taken at the correct time at the beginning of reflexology treatment being undertaken that shows a poor result, can then be used again to monitor progress and is a very useful tool for practitioners.  Most clients will be given a lab slip that allows them to present themselves for testing at the appropriate time, which means that with your support they can have their test taken at the correct time in their menstrual cycle.

Reproflexology^TM  uses prescriptive treatment protocols to work at correcting each stage of the menstrual cycle, and a wide range of reproductive conditions, including progesterone deficiency.  This allows us to ensure that each component part of the cycle is working effectively and is able to support ovulation, fertilization, implantation and pregnancy. Working with males is of the utmost importance, but I know that it can be tricky to encourage them to present for treatment, as they tend to be much more skeptical about reflexology as a form of treatment.  Even more so when it comes to working reproductively, and many will only attend under the ‘suggestion’ of their partner.  However, if we can get to see them at initial consultation then that is a huge step in the right direction, as it does allow us to, at least, to gather the information that is needed to complete the picture of what issues might be affecting their fertility as a couple.

In general, in the UK, if couples have been trying to conceive for 12 months without success (6 months if they are over 35), then they can ask their GP for some base line tests to ascertain whether there are any obvious reasons for their inability to get pregnant. We have already looked at one of these tests for women (although there are a number of others), but for men, it should be a semen analysis. If your clients do have a semen analysis, please do make sure that you ask them to provide you with a copy of the result, as it is possible that they will have been told that all is well, when things are not quite what they seem. Many GPs presume that even if men are producing low numbers of sperm that there is still a possibility of conception, when we know this is not the case. Additionally, fertility clinics will be looking at results from the point of view, of using IVF/ICSI and not natural conception, so they may also have been told that all is well, when the results show something quite contrary to this.

A basic semen analysis should measure

• Volume - the amount of seminal fluid produced;
• Count - which is the number of sperm in each ml of seminal fluid and an overall count;
• Motility - the number of sperm that are ‘swimming’ and whether they are swimming progressively;
• Morphology - the formation of the sperm, and what kind of defects they might have. i.e. head, mid-piece or tail defects;

All of the above factors are relevant, in terms, of sperm health and their ability to fertilize an ovum.

The current World Health Organization lower reference ranges are as follows:

Volume    1.5 - 4 ml

Count    15ml per ml

Total Count    39 million

Motility    40%

Progressive Motility    32%

Morphology    4%

Sperm take approximately 90-100 days to develop and mature, which means that when you are reading test results, the sperm were produced approximately 3 months previously.  This is key to interpreting results, as you will need to factor this in when discussing with clients what might be affecting their most recent result.  It could be something as simple as a fever, a period of high stress levels or some emotional or physical trauma.  It is also important to understand that sperm production fluctuates constantly and so sometimes repeating a test is useful.

Reproflexology^TM uses a twelve week protocol, with semen analysis at the beginning and end of treatment to measure the affects of treatment. Male fertility has declined by 50% in the last 25 years in the UK (and in many other countries too), this means that we need to be educating, informing and engaging males in the process more than ever. The most effective way of doing this is by using an initial consultation that does not involve any formal treatment.  It also allows you plenty of time to gather the correct information, build a professional relationship with your client, explain the work that you are going to be doing with them, treatment plan and allow your clients to ask questions.  I use a pre-conceptual questionnaire that is sent out to clients prior to their appointment, and I ask them to bring it with them along with copies of any relevant test results, I do also state that I like to see both of them at Initial Consultation.  This means that you have the beginnings of the pieces of information that you will need to build a picture of what is happening for the couple that you are working with. It also means that you have had the opportunity of engaging with your male client and answering any questions or reservations he may have, and he is then able to make an informed choice about his treatment options.

Working with clients with fertility issues can be one of the most challenging, interesting ad rewarding specialisms, but also one in which you need to take great care of yourself and your clients.  It can be demanding on many different levels and it is vital that you construct clear professional boundaries very early on in your working relationship, so that any discussions you may have are never misconstrued.

In 2011, along with some former students, I formed the Association of Reproductive Reflexologists, which has allowed us to do a number of things, a few of which are:

• Continue to develop knowledge and training;
• Support practitioners when working in this specialism;
• Develop links/collaborate with the medical profession;
• Promote Reproductive Reflexology and our practitioners;
• Develop a presence at The Fertility Show (Olympia, London);
• And undertake a data collection study.

We carried out a data collection study of 180 cases and found that the success rate was proven to be 68% of all cases, whether they were undertaking IVF or natural conception.  We then extrapolated this data into individual conditions.  The data is listed below and you will see that there is a distinct difference between the conception rate and the Live Birth Rate.  With some conditions the miscarriage rate is higher and this is usually because this is a known possibility with this particular kind of condition. It is important to be aware that these results can only be attributed to using these particular protocols and no other forms of reflexology.

• 180 cases
• 68% success rate
• 100 - Natural Conception
• 22 with Assisted Conception
• Age range of 24 - 46
• Average number of treatments undertaken  - 11.32

For those clients for whom there was ‘No Diagnosis’

Pregnancy - 70%         Live Birth Rate - 70%

Endometriosis

Pregnancy - 65%         Live Birth Rate - 55%

PCOS

Pregnancy - 72%         Live Birth Rate - 57%

Amenorrhea

Pregnancy - 91%         Live Birth Rate - 70%

Sperm Motility Issues

Pregnancy - 100%       Live Birth Rate - 50%

Sperm Morphology

Pregnancy - 50%         Live Birth Rate - 50%

Ovarian Cysts

Pregnancy - 100%       Live Birth Rate - 100%

Progesterone deficiency

Pregnancy  50%          Live Birth Rate  100%

The results of our data collection have been presented at The Reflexology in Europe Network conference, The Fertility Show and in a number of publications.

Comments from some of our practitioners

Bibliography and Further Reading

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

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

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

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

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

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

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

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

9.         Greer Prof, I, Fertility and Conception, Collins, 2007.

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