IVF and Fertility and Research

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Effects of acupuncture on rates of pregnancy and live birth among women undergoing in vitro fertilisation: systematic review and meta-analysis.
Manheimer E et al. BMJ 2008;336 pg 545-549
British Medical Journal

A systemic review and Meta analysis of seven clinical trials involving 1366 women.

  • Acupuncture increased the clinical odds of achieving a pregnancy by 65%
  • That means that for every 10 women receiving Acupuncture one extra pregnancy was achieved
  • Acupuncture is a safe therapy to use with IVF and in early pregnancy
  • Acupuncture is a cost effective adjunct to IVF

For the full text paper please visit:
http://www.bmj.com/cgi/content/full/bmj.39471.430451.BEv1

 

Influence of acupuncture on the pregnancy rate in patients who undergo assisted reproduction therapy
Paulus W et al, Fertil Sterility2002 Vol 77, pg 721-724

Prospective randomized study. 160 patients. Acupuncture administered before and after embryo transfer.

  • 42.5% of women in the Acupuncture group achieved clinical pregnancy compared to 26.3% in the control.
  • Pregnancy was determined but the presence of a fetal sac detectable by ultrasound 6 weeks after transfer.
  • Acupuncture seems to be a useful tool for improving pregnancy rates after ART.

 

Influence of acupuncture stimulation on pregnancy rates for women undergoing embryo transfer,
Smith C et al, Fertil Steril 2006 Vol 85, pg 1352-1358
Fertility and Sterility

Single blind, randomized, controlled trial. 228 women undergoing IVF.

  • Pregnancy rate 31% in Acupuncture group Vs 23% in the control.
  • Odds of achieving a pregnancy were 1.5 times higher in the Acupuncture group.
  • Ongoing pregnancy at 18 weeks was higher in the Acupuncture group 28% Vs 18% in the control.
  • Acupuncture is a safe treatment to undertake during IVF therapy.
  • A benefit was reported across all age groups.

 

Effect of acupuncture on the outcome of in vitro fertilization and intracytoplasmic sperm injection: a randomized, prospective, controlled clinical study
Dieterle S et al, Fertil Steril 2006 Vol 85, pg 1347-1351
Fertility and Sterility

Dieterle S, Ying G, Hatzman W & Neuer A

  • A randomized, prospective, controlled clinical trial. 225 women undergoing IVF/ICSI.
  • Clinical pregnancy rate for Acupuncture group 33.6% Vs 28.4% in control group.
  • Ongoing pregnancy rate 15.6% in Acupuncture group compared to 13.8% in control.
  • Luteal phase Acupuncture has a positive effect on the outcome of IVF/ICSI.

 

Acupuncture on the day of embryo transfer significantly improves the reproductive outcome in infertile women: a prospective, randomized trial
Westergaard L et al, Fertil Steril 2006 Vol 85, pg 1341-1346
Fertility and Sterility

  • Patients who received Acupuncture on the day of embryo transfer had a statistically higher clinical and ongoing pregnancy rate than the control who received no Acupuncture

 

Impact of acupuncture before and after embryo transfer on the outcome of in vitro fertilization cycles: A prospective single blind randomized study
Benson M. R. et al, Fertil Steril 2006 Vol 86, Issue 3, pg S135
Fertility and Sterility

  • Acupuncture group had higher pregnancy rates compared to all control groups (sham acupuncture, laser acupuncture, relaxation only)

 

Acupuncture performed before and after embryo transfer improves pregnancy rates.
Youran D et al Fertil Steril 2008 Vol. 90, Suppl 1, pg S240
Fertilty and Sterility

  • Pregnancy rates improved in Acupuncture group

 

The effect of acupuncture in assisted reproduction techniques
Teshima D. R. K et al, Fertil Steril 2007 Vol 88, Suppl 1, pg S330
Fertility and Sterility

  • Higher pregnancy rates in Acupuncture group

 

The effect of acupuncture on outcomes in in-vitro fertilization (IVF)
Udoff L. C. et al, Fertil Steril 2007 Vol 86, Issue 3, pg S145
Fertility and Sterility

  • statistically significant higher biochemical pregnancy rate in Acupuncture
  • trend in Acupuncture group for more ongoing clinical pregnancy and take home baby rates
  • More research warranted into Acupuncture and its impact on pregnancy rates in IVF

 

A randomized, controlled, double-blind, cross-over study evaluating acupuncture as an adjunct to IVF
Quintero R et al, Fertil Steril 2004 Vol 81 Suppl 3, pg S11-12
Fertility and Sterility

  • Significantly lower amount of gonadotropin used when IVF is combined with standard acupuncture.
  • A 70% pregnancy rate was also achieved with standard acupuncture and IVF, compared to 25%.
  • Larger prospective trials are necessary.

 

Acupuncture & IVF poor responders: a cure?
Magarelli P,Cridennda D, Fertil Steril,2004;81 Suppl 3 S20
Fertility and Sterility

  • Significant increases in pregnancy outcomes were confirmed by this study and the data uniquely supported the advantage of acupuncture in patients with normal PI
  • We also demonstrated that both acupuncture treatment protocols could be used together with a synergistic effect.
  • Finally, this study is the first to demonstrate that the use of acupuncture in patients with poor prognoses (elevated Peak FSH, longer history of infertility, poor sperm morphology) can achieve similar pregnancy rates to normal prognosis patients.

 

Acupuncture Treatment For Infertile Women Undergoing Intracytoplasmic Sperm injection
Emmons S and Patton P, Medical Acupuncture 2000, 12 (2) 18 – 20
Medical Acupuncture

  • Conclusion Acupuncture may be a useful adjunct to gonadotropin therapy to produce follicles in women undergoing in vitro fertilization.

 

Influence of Acupuncture on Infertility in Rats with Polycystic Ovarian Syndrome
Zhang Wei Yi et al, Chinese Jnl Integrated Traditional and Western Med 2009 Nov (8), 973
Chinese Journal of Integrated Traditional and Western Medicine

  • Acupuncture can significantly down-regulate the expressions of serum levels of T and E2, improve the development of ovaries and uterus, promote ovulation, enhance endometrial receptivity, and advance blastocyst implantation.

 

Effect of acupuncture on the pregnancy rate in embryo transfer and mechanisms: A randomized and controlled study
Zhang M et al, Chin Acup and Moxabustion 2003, Jan 23 (1): 3 – 5
Chinese Acupuncture and Moxabustion

  • The pregnancy rate was 44.3% (31/70) in the acupuncture treatment group, and 27.1% (19/70) in the placebo group and 24.3% (17/70) in the control group.
  • The pregnancy rate in the acupuncture treatment group was significantly higher than that in the placebo acupuncture group and the control group (P0.05).
  • Conclusion Acupuncture is a powerful tool for improving pregnancy rate after assisted reproduction therapy.

 

Use of Acupuncture before and after embryo transfer
Dalton-Brewer N et al, Hum Fert 2010 Vol 12 No 4 212 – 255
Human Fertility (abstracts from UK Fertility Societies Conference 2009)

  • Results for women aged 35–39 years and those over 40 years were markedly better than controls suggesting that acupuncture intervention of this type may be more effective in older women.
  • No side effects or complications were experienced by women receiving acupuncture. Acupuncture is a safe, adjunct therapy in IVF and in other randomised clinical trials has been shown to significantly improve outcomes when used at the IVF centre before and after embryo transfer.

 

Traditional Chinese medicine and infertility.
Huang, S T and Chen, A P C, Current Opinion in Obstetrics & Gynecology. 2008, 2(3):211-215.
Current Opinion in Obstetrics & Gynecology

  • The growing popularity of traditional Chinese medicine used alone or in combination with Western medicine highlights the need to examine the pros and cons of both Western and traditional Chinese medicine approaches.
  • Integrating the principle and knowledge from well characterized approaches and quality control of both traditional Chinese medicine and Western medical approaches should become a trend in existing clinical practice and serve as a better methodology for treating infertility.

 

Acupuncture and Assisted Conception
Cheong Y et al, Cochrane Database of Systematic Reviews 2008, Issue 4.
Cochrane Review

  • The data from this meta-analysis suggests that acupuncture performed on the day of ET does increase the clinical pregnancy rate of IVF treatment; however, this could be attributed to placebo effect and the small number of patients included. Further larger RCTs are necessary to confirm the results.

 

Stressful Life Events are Associated with a Poor In-vitro Fertilization (IVF) Outcome: A Prospective Study
Ebbesen S.M.S. Hum Reprod 2009;24(9):2173-2182.
Human Reproduction

  • A large number of life-events perceived as having a negative impact on quality of life may indicate chronic stress, and the results of our study indicate that stress may reduce the chances of a successful outcome following IVF, possibly through psychobiological mechanisms affecting medical end-points such as oocyte retrieval outcome.

 

Stress reduces conception probabilities across the fertile window: evidence in support of relaxation.
Buck Louis GM et al, Fertil Steril. 2010 Jul 30. [Epub ahead of print]
Fertility and Sterility

  • Stress significantly reduced the probability of conception each day during the fertile window, possibly exerting its effect through the sympathetic medullar pathway.

 

The relationship between perceived stress, acupuncture, and pregnancy rates among IVF patients: A pilot study
Balk J et al, Complementary Therapies in Clinical Practice, Online 24 December 2009
Complementary Therapies in Clinical Practice

  • The acupuncture regimen was associated with less stress both before and after embryo transfer, and it possibly improved pregnancy rates.
  • Lower perceived stress at the time of embryo transfer may play a role in an improved pregnancy rate.

 

An assessment of the demand and importance of acupuncture to patients of a fertility clinic during investigations and treatment
Hinks J and Coulson C, Hum Fert 2010 Vol 13, S1 Pg 3-21
Human Fertility

  • The responses to the questionnaires indicate a clear demand for acupuncture and suggest that acupuncture may be valuable to improve the general wellbeing of women during infertility investigations and treatments.
  • If acupuncture provides an effective coping mechanism, this could support patients to persevere with increased numbers of ART(Assisted Reproductive Technologies) cycles, thereby increasing their ultimate chance of a successful pregnancy.

 

Building resilience: An exploration of women’s perceptions of the use of acupuncture as an adjunct to IVF
De Lacey S, Smith C and Paterson C, BMC Complementary and Alternative Medicine 2009, 9:50
BioMed Central

  • This preliminary exploration, whilst confined to a small sample of women, confirms that acupuncture is indeed perceived by infertile women to have an impact to their health.
  • All findings outlined here are reported cautiously because they are limited by the size of the sample.

They suggest that further studies of acupuncture as an adjunct to IVF should systematically explore the issues of wellbeing, anxiety, personal and social resilience and women’s identity in relation to sexuality and reproduction

 

Understanding Women’s views towards the use of Acupuncture while undergoing IVF treatment.
Smith C and De Lacey S, 2008 In press
FSA conference 2008

  • Acupuncture is an effective and low intensity procedure for increasing women’s resilience in the repetitive and stress inducing time of pregnancy attempts, with or without medical treatment.
  • The instrumental role of the acupuncture therapist in increasing resilience is a finding that has not emerged in previous studies and has implications for patient management.