The role of naturopathy in the management of women with diminished ovarian reserve

Abstract

Women with diminished ovarian reserve (DOR) have fewer oocytes than would be expected at their age, compromising fertility. The prevalence of DOR is unclear however it is estimated to affect about 10% of women seeking medically assisted reproduction (MAR) treatment. Current guidelines for the management of DOR are unclear, with most women being referred for MAR. Yet DOR is characterized by decreased fertility and poor reproductive outcomes even when MAR techniques are used. Many women in Australia explore all available treatment options to enhance their fertility including traditional complementary and integrative medicine (TCIM). Naturopathy is a popular type of TCIM practice used by women to improve reproductive and wellbeing health outcomes. However, the evidence of effectiveness and safety for naturopathy in women with infertility is limited, and there is no evidence regarding the way that naturopaths approach and manage care of women with DOR. The effectiveness of naturopathic treatment could inform the decisions of women with DOR and multidisciplinary management of infertility. The aim of this thesis was to investigate the role of naturopathy in the management of women with DOR.
Women with DOR require health care beyond addressing infertility, particularly mental health support. The main form of treatment utilised is MAR, despite pregnancy and live birth rates remaining low. Acupuncture, meditation, naturopathy, massage, and yoga are TCIM practices used as adjunct treatments by women with DOR, with perceived benefits including enhanced fertility, supported pregnancy, and improved well-being. The naturopathic approach to management of women with infertility incorporates physical, emotional, social, and environmental aspects. Key treatments included lifestyle changes and nutritional supplements aimed at improving general well-being and fertility outcomes. Evaluation of the effectiveness of whole-system naturopathy in addition to usual care was feasible, acceptable, and well-tolerated according to women with DOR. This thesis potentially informs women with DOR, naturopathic practice, associated health professionals, researchers and future RCT design. Further research evaluating the effectiveness and safety of naturopathy for women with DOR is necessary to inform the profession and clarify the role of naturopathy within a multidisciplinary approach to infertility.

Date of Award	2024
Original language	English
Awarding Institution	Western Sydney University
Supervisor	Carolyn Ee (Supervisor)