In many modern societies people are waiting longer to start their families, often until their early or mid thirties.  Because of this, questions have arisen about how age affects the ability of a woman to get pregnant.

Women typically have a decrease in fertility beginning in their early 30s.  On average, a woman in her mid-30s or older will take longer to conceive than a younger woman.  At age 30 to 35, fertility is 15 to 20 percent below maximum.  From age 35 to 39, the decrease is 25 to 50 percent.  From 40 to 45, the decrease is 50 to 95 percent.

Age-related declines in fertility may be at least partly due to less frequent ovulation or to other problems such as endometriosis.  Endometriosis is a condition in which tissue similar to that lining the uterus attaches to the ovaries or fallopian tubes and interferes with conception.

If you are over 35 and trying to conceive, you should see a physician after trying for around six months.  Some studies have shown that about one-third of women between age 35 and 39 and two-thirds of women over 40 have fertility problems.  When they do get pregnant, women older than 35 may have a higher risk of developing gestational diabetes, preeclampsia, and placenta previa. There is also a potentially higher risk of having a baby with low birth weight, and of chromosomal abnormalities such as Down syndrome.

Many cases of infertility can be treated successfully.  While women over age 35 may have more difficulty conceiving, they also have a greater chance of bearing twins. The likelihood of naturally conceived (without fertility treatment) twins peaks between ages 35 and 39.

Earlier this year, new official guidance said that patients with persistent lower back pain should be offered acupuncture on the NHS. The recommendation, from the NHS rationing body NICE, said that the scientific evidence now showed that acupuncture was not only effective at treating back pain, but also cost effective when other treatments, such as painkillers, were found not to be working.

Up to now, the scientific rationalists among us would have had grounds for pooh-poohing all this as unproved, pricey pampering. But that’s all changed. Science has suddenly — and very publicly — taken a turn in favour of the needle.

The new guidance came from a report from the influential medical research review body ‘the Cochrane Collaboration’, saying that headache and migraine sufferers clearly fared better with acupuncture than painkillers. In addition, a large scientific review found that women undergoing fertility treatment were more likely to give birth successfully if they had acupuncture.

Not everyone believes it works

The short answer is that Acupuncture does work — for head and back pain. But for everything else, it depends on whom you talk to. And many Doctors are still sceptic.

Professor Edzard Ernst, chair of complementary therapy at Exeter and Plymouth universities, is doubtful. He says that you need to study the effects on thousands of people before you can say “this works” or recommend that people should pay for a treatment. In addition, he doesn’t buy the supposed evidence on fertility.

One of his worries is whether acupuncture actually has any effect on the body, or whether it’s simply a glorified “placebo” — a treatment that makes us feel better simply because we expect to be made better. If it is just a trick of the light, should the NHS — or anyone — be paying for it?

The evidence that it works is there but sham acupuncture works as well
In fact, pretty strong evidence that acupuncture kills pain and helps nausea sufferers.

At the same time , administering “sham” acupuncture — where needles are inserted into the wrong place, or aren’t pushed in properly, or toothpicks are applied to the skin instead — often seem to have the same effect. To the sceptics, this suggests that acupuncture doesn’t actually have a curative effect: it just cons people into feeling well.

The concept behind the needles
Acupuncture brings a real neurophysiological response, which is more than placebo. Touching, pressure, pointing to where the pain is all have an effect, and you can measure their effects in the nervous system.

The idea of energy in acupuncture is a huge concept. But basically inserting a needle provokes an electrical and biochemical response which promotes communication between cells. It’s been shown that it ignites the brain with electrical lights.

It’s all about costs
So why did the NHS introduce Acunpucture ? Better it’s cost effective. First, not everyone will be able to get treatment. Second the costs to the NHS would be minimal – in the order of £77,000 – because they are offset by the savings in terms of reducing future disability and healthcare needs and moving away from treatments with little supportive evidence.

The guidelines, which apply to England and Wales, say doctors should no longer offer spinal x-rays or MRI scans or injections of therapeutic substances into the back for non-specific low back pain.

The Chartered Society of Physiotherapy welcomed the guidelines, as did Dr Dries Hettinga of the charity BackCare. He said: “This offers a real choice for patients.
“This guideline will help patients understand what treatment and care can help them with their back pain and shows that there can be a positive outlook for treating this condition.”

Conclusion
Proof is a hard thing to come by for any treatment, and acupuncture is going to take longer than most to crack. In the meantime, spending your painkiller cash on a relaxing acupuncture session doesn’t seem such a stupid move. Try it !