title: Australian women's use of complementary and alternative medicines to enhance fertility: exploring the experiences of women and practitioners.
abstract: BACKGROUND
  Studies exploring the use of complementary and alternative medicine (CAM) to enhance fertility are limited. While Australian trends indicate that women are using CAM during pregnancy, little is known about women's use of CAM for fertility enhancement. With the rising age of women at first birth, couples are increasingly seeking assisted reproductive technologies (ART) to achieve parenthood. It is likely that CAM use for fertility enhancement will also increase, however this is not known. This paper reports on an exploratory study of women's use of CAM for fertility enhancement.
  
  
  METHODS
  Three focus groups were conducted in Melbourne, Australia in 2007; two with women who used CAM to enhance their fertility and one with CAM practitioners. Participants were recruited from five metropolitan Melbourne CAM practices that specialise in women's health. Women were asked to discuss their views and experiences of both CAM and ART, and practitioners were asked about their perceptions of why women consult them for fertility enhancement. Groups were digitally recorded (audio) and transcribed verbatim. The data were analysed thematically.
  
  
  RESULTS
  Focus groups included eight CAM practitioners and seven women. Practitioners reported increasing numbers of women consulting them for fertility enhancement whilst also using ART. Women combined CAM with ART to maintain wellbeing and assist with fertility enhancement. Global themes emerging from the women's focus groups were: women being willing to 'try anything' to achieve a pregnancy; women's negative experiences of ART and a reluctance to inform their medical specialist of their CAM use; and conversely, women's experiences with CAM being affirming and empowering.
  
  
  CONCLUSIONS
  The women in our study used CAM to optimise their chances of achieving a pregnancy. Emerging themes suggest the positive relationships achieved with CAM practitioners are not always attained with orthodox medical providers. Women's views and experiences need to be considered in the provision of fertility services, and strategies developed to enhance communication between women, medical practitioners and CAM practitioners. Further research is needed to investigate the extent of CAM use for fertility enhancement in Australia, and to explore the efficacy and safety of CAM use to enhance fertility, in isolation or with ART.
authors.affiliation: Mother and Child Health Research, La Trobe University, 324-328 Little Lonsdale St, Melbourne, Victoria 3000, Australia. j.rayner@latrobe.edu.au
authors.forename: Jo-Anne
authors.initials: JA
authors.lastname: Rayner
authors.forename: Helen L
authors.initials: HL
authors.lastname: McLachlan
authors.forename: Della A
authors.initials: DA
authors.lastname: Forster
authors.forename: Rhian
authors.initials: R
authors.lastname: Cramer
mesh_terms: D000328:Adult; D001294:Attitude to Health; D001315:Australia; D000529:Complementary Therapies / Q000706:statistics & numerical data*; D005260:Female; D005298:Fertility; D017144:Focus Groups; D019538:Health Care Surveys; D006801:Humans; D007246:Infertility / Q000628:therapy*; D011247:Pregnancy; D011369:Professional-Patient Relations; D027724:Reproductive Techniques, Assisted / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D016387:Women's Health