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Continuing Professional Development
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THE COMPLEMENTARY APPROACH
with multivitamins. Avoiding smoking and
alcohol would be advisable, keeping to
a healthy weight range with regular (but
not excessive) exercise, and addressing
methods to cope with stress. For women
undergoing IVF, CoQ10 may be considered
at doses of up to 600 mg a day to enhance
the mitochondrial activity of the developing
follicles. Acupuncture may be supportive of
IVF outcomes when undertaken pre- and
post-embryo transfer. Vitex agnus-castus
may be relevant for women who have luteal
phase deficiency or secondary amenorrhoea,
but should not be prescribed during IVF
cycles without consultation with the medical
Key learning points
• A blood test for Vitamin D and
subsequent supplementation can be
useful to assist optimal fertility.
• Ensure adequate but safe sun exposure
for adequate vitamin D levels.
• Stress management would be helpful
for women experiencing infertility or
• Consume a diet rich in naturally-
occurring antioxidant nutrients from
fruit, vegetables and wholegrains as well
as omega 3 fatty acids from fish.
• Avoiding smoking and alcohol for
• For underweight or obese women,
weight management may improve
fertility and IVF outcomes.
1. Herbert DL, Lucke JC, Dobson AJ. Infertility, medical advice and
treatment with fertility hormones and/or in vitro fertilisation:
a population perspective from the Australian Longitudinal
Study on Women's Health. Aust N Z J Public Health. 2009;
2. Healy DL, Trounson AO, Andersen AN. Female infertility: causes
and treatment. Lancet. 1994; 343(8912):1539--44.
3. Rayner JA, Willis K, Burgess R. Women's use of complementary
and alternative medicine for fertility enhancement: a review of
the literature. J Altern Complement Med. 2011; 17(8):685--90.
4. Sarris J, Wardle J. Clinical Naturopathy An evidence-based guide
to practice. NSW: Elsevier Australia; 2010.
5. Chavarro JE, Rich-Edwards JW, Rosner BA, et al. Diet and lifestyle
in the prevention of ovulatory disorder infertility. Obstet
Gynecol. 2007; 110(5):1050--8.
6. Dondorp W, de Wert G, Pennings G, et al. Lifestyle-related factors
and access to medically assisted reproduction. Hum Reprod.
7. Augood C, Duckitt K, Templeton AA. Smoking and female
infertility: a systematic review and meta-analysis. Hum Reprod.
8. Rossi BV, Berry KF, Hornstein MD, et al. Effect of alcohol
consumption on in vitro fertilization. Obstet Gynecol. 2011;
9. Vrekoussis T, Kalantaridou SN, Mastorakos G, et al. The role of
stress in female reproduction and pregnancy: an update. Ann N
Y Acad Sci. 2010; 1205(1):69--75.
10. Domar A. Participation in stress management program results
in increased pregnancy rate. Atlanta: American Society for
Reproductive Medicine; 2009.
11. Ebbesen SMS, Zachariae R, Mehlsen MY, et al. Stressful life events
are associated with a poor in-vitro fertilization (IVF) outcome: a
prospective study. Hum Reprod. 2009; 24(9):2173--82.
12. Anderson K, Norman Robert J, Middleton P. Preconception
lifestyle advice for people with subfertility. Cochrane Database
of Systematic Reviews. Chichester, UK: John Wiley & Sons, 2010.
13. Kinuta K, Tanaka H, Moriwake T, et al. Vitamin D is an important
factor in estrogen biosynthesis of both female and male
gonads. Endocrinol. 2000; 141(4):1317--24.
14. Lubna P, et al. Vitamin D can aid fertility. San Francisco: American
Society of Reproductive Medicine; 2008.
15. Ozkan S, Jindal S, Greenseid K, et al. Replete vitamin D stores
predict reproductive success following in vitro fertilization. Fertil
steril. 2010; 94(4):1314--19.
16. Anifandis G, Dafopoulos K, Messini C, et al. Prognostic value of
follicular fluid 25-OH vitamin D and glucose levels in the IVF
outcome. Reprod Biol Endocrinol. 2010; 8(1):91.
17. Braun L, Cohen M. Herbs & natural supplements: an evidence
based guide. 3rd edn. Australia: Elsevier; 2010.
18. Oates L. Complementary medicines for asthma. Aust Pharm.
2011: 30(6)488--90, 92--93.
19. Liu J, Burdette JE, Xu H, et al. Evaluation of estrogenic activity
of plant extracts for the potential treatment of menopausal
symptoms. J Agric Food Chem. 2001; 49(5):2472--79.
20. Jarry H, Leonhardt S, Gorkow C, et al. In vitro prolactin but not
LH and FSH release is inhibited by compounds in extracts of
agnus castus: direct evidence for a dopaminergic principle
by the dopamine receptor assay. Exp Clin Endocrinol. 1994;
21. Gorkow C, Wuttke W, Marz RW. Effectiveness of Vitex
agnus-castus preparations. Wien Med Wochenschr. 2002;
22. Gerhard II, Patek A, Monga B, et al. Mastodynon(R) bei weiblicher
Sterilitat. Forschende Komplementarmedizin. 1998; 5(6):272--8.
23. Boxmeer JC, Macklon NS, Lindemans J, et al. IVF outcomes are
associated with biomarkers of the homocysteine pathway in
monofollicular fluid. Hum Reprod. 2009; 24(5):1059--66.
24. Ebisch IMW, Thomas CMG, Peters WHM, et al. The importance
of folate, zinc and antioxidants in the pathogenesis and
prevention of subfertility. Hum Reprod Update. 2007;
25. Saldeen P, Saldeen T. Women and Omega-3 Fatty Acids. Obs
Gynecol Surv. 2004; 59(10):722--30.
26. Burstein E, Perumalsamy A, Bentov Y, et al. Co-enzyme Q10
supplementation improves ovarian response and mitochondrial
function in aged mice. Fertil steril. 2009; 92(3):S31.
27. Bentov Y, Esfandiari N, Burstein E, et al. The use of mitochondrial
nutrients to improve the outcome of infertility treatment in
older patients. Fertil steril. 2010; 93(1):272--5.
28. Manheimer E, Zhang G, Udoff L, et al. Effects of acupuncture on
rates of pregnancy and live birth among women undergoing
in vitro fertilisation: systematic review and meta-analysis. BMJ.
29. Cheong Ying C, Hung Yu Ng E, Ledger William L. Acupuncture
and assisted conception. Cochrane Database of Systematic
Reviews. Chichester, UK: John Wiley & Sons, 2008.
30. Sunkara SK, Coomarasamy A, Khalaf Y, et al. Acupuncture and in
vitro fertilization: updated meta-analysis. Hum Reprod. 2009.
1. Which of the following statements is
TRUE with regard to vitamin D use in
women with infertility?
a) Adequate vitamin D stores may
have a positive influence on clinical
pregnancy in IVF.
b) Monitoring of vitamin D levels is
recommended as one study has
found excess levels of vitamin D may
compromise IVF results.
c) In a study it was found that 39% of
patients with ovulatory disturbances
were vitamin D deficient.
d) All of the above.
2. Which of the following statements
about lifestyle and IVF is TRUE?
a) Obesity is not associated with a higher
risk of neural tube defects.
b) A diet with low trans fats, vegetable
rather than animal protein, high fat
dairy and lower glycaemic index
carbohydrates plus a multivitamin and
iron (from plant foods or supplement)
can enhance health and fertility.
c) Smoking does not affect length of time
d) All of the above.
3. Which of the following statements
is TRUE with regard to Vitex agnus-
castus and fertility?
a) Vitex may be used by women with
luteal insufficiency, pre-menstrual
symptoms or secondary amenorrhoea.
b) Large scale RCT trials have shown
that Vitex can be useful for patients
c) Vitex stimulates serotonin receptor
d) All of the above.
4. According to a meta-analysis:
a) acupuncture should be recommended
once a month at the start of the
b) in an IVF cycle, acupuncture
undertaken close to embryo transfer
may improve live birth rates.
c) acupuncture is definitely not effective
for women with fertility issues.
d) acupuncture is useful to assist in
IVF outcome but the timing of the
acupuncture is not important.
5. Which of the following has been
associated with a reduced likelihood
b) Physiological stress.
c) Emotional stress.
d) All of the above.
A score of 4 out of 5 attracts 1 CPD credit.
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