Anovulation is just like   unopened buds. The result is no fertilisation.

Reproductive acupuncture vs medication for anovulation

Interested know how reproductive acupuncture scores against medication at improving ovulation and ovarian health?

One of the causes for anovulation is luteinised unruptured follicle syndrome (LUFS). LUFS affects 5%-10% of healthy women of childbearing age and 25%-43% of women with infertility. This syndrome is more common among women diagnosed with endometriosis.

Most commonly LUFS is diagnosed during series of ultrasound scans. In women with LUFS the dominant follicle will grow bigger than usual (up to 4 centimetres). The follicle will undergo the luteinisation process, but it will not rupture during the midcycle to release the mature egg. Progesterone secretion will increase, the endometrium will undergo the secretory changes. Your won’t be able to see any difference in your period. The menstrual flow will be no different to healthy menstrual cycle; but, obviously, if oocyte is not released, fertilisation and pregnancy cannot happen. Pathogenesis of LUFS is poorly understood. The main treatment is ovulation induction with hCG hormonal injection or Chlomiphene. These treatments are a risk of hyperstimulation syndrome and other side-effects.

A recent literature review on acupuncture’s effect on LUFS has been published in Journal Of Acupuncture and Tuina Science. And if offers a safe and effective alternative. Read more

Hyperprolactinemia: reproductive acupuncture holds a promise

hyperprolactinemia-prolactinomaHyperprolactinemia can be a significant obstacle for women trying to get pregnant, and reproductive acupuncture may be one way to address the condition in some women. Previous research has shown that acupuncture influences prolactin levels in women undergoing IVF. We have studies showing acupuncture can reduce prolactin levels (auricular acupuncture using NADA protocol).

This study is interesting, because the researchers were looking at natural conception rates; and women who had acupuncture treatment showed significant difference – they were more fertile. Acupuncture plus standard treatment resulted in 43% pregnancy rate vs 20% of standard treatment alone. Bromocriptine has some nasty side-effects, including dizziness, nausea, confusion, even hallucinations and uncontrolled body movement. Women undergoing acupuncture treatment had much better response to the drug, but also had fewer side-effects.

Obviously, this is a small study; and further research looking into hyperprolactinemia and acupuncture are needed. The abstract of the study is below.

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Can acupuncture help 35+ year old pregnant women reduce pregnancy risks

pregnant maternal age

Can acupuncture help 35+ year old pregnant women reduce pregnancy risks?

Women of this age, are a high risk for developing stillbirth and fetal growth restriction among other complications.

This study, published in journal of Physiology, researchers from University of Manchester, UK concluded that the blood flow to placenta may be the reason for increased risks. Acupuncture increases the blood flow to uterus. Use acupuncture in pregnancy as preventative measure to reduce the risks for the developing baby.

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PCOS: acupuncture normalises ovarian volume and AMH

Obstetricia-Gynecologica-pcos-amh

Acupuncture helps to normalise both ovarian volume and AMH in PCOS patients. These changes are beneficial for fertility.

Both acupuncture and exercise help to normalise overactive sympathetic nervous system in PCOS patients. Acupuncture, however, is much more effective.  Furthermore, as shown by this study, exercise has no effect on AMH nor ovarian volume.

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PCOS insulin resistance – Acupuncture can help

PCOS insulin resistance acupuncturePCOS can improve with acupuncture treatment. More research looks into the mechanism of it. One of the lead researchers in PCOS and acupuncture Dr Elisabet Stener-Victorin from Sweden has long suspected that acupuncture may play a role in regulating blood glucose levels and helping with insulin resistance. Insulin resistance is one of the features of PCOS. This study put the theory to test.

The study revealed acupuncture increases whole body glucose uptake during and after stimulation in women with polycystic ovary syndrome.  See the abstract and a full text of the study below.

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Electro acupuncture decreases risk of Ovarian Hyperstimulation in IVF patients

ohssThis study shows acupuncture in IVF patients decreases the risk of ovarian hyperstimulation. And while it has some limitations, we need to take the results into account while choosing the right acupuncture protocol for each IVF patient.

The study was published in Chinese Journal of Integrated Traditional and Western Medicine.

[Effect of electro-acupuncture on clinical outcomes and ovarian hyperstimulation syndrome in in vitro fertilization and embryo transplantation].
(PMID:25566616)

Hong YL, Tan Y, Yin YY, Zou YJ, Guo YH, Nie XW
Department of Gynecology, Nanjing University of Chinese Medicine, China.
Zhongguo Zhong xi yi jie he za zhi Zhongguo Zhongxiyi Jiehe Zazhi = Chinese Journal of Integrated Traditional and Western Medicine / Zhongguo Zhong xi yi jie he xue Hui, Zhongguo Zhong yi yan jiu Yuan zhu ban [2014, 34(11):1292-1296]

OBJECTIVE: To observe the effect of electro-acupuncture (EA) on clinical outcomes and the occurrence of ovarian hyperstimulation syndrome (OHSS) in in vitro fertilization and embryo transplantation.

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Acupuncture improves receptivity of endometrial lining in IVF Frozen Embryo Transfer

Frozen embryo transfer acupuncture

IVF Frozen Embryo Transfer (FET) patients benefit from Acupuncture. This helps us understand how Acupuncture benefits fertility.

Electro stimulation on acupuncture points leading to the IVF transfer improves the quality/receptivity of the uterine lining. A study published in the latest issue of peer-reviewed British Medical Journal (Acupuncture in Medicine) found the rates of embryo implantation, clinical pregnancy and live birth rates were higher in patients who received acupuncture leading to the transfer. They also found significant measurable changes in the endometrium (uterine lining):

  • Acupuncture improved the chances of triple-line pattern endometrial lining. It has been shown in studies that triple-line pattern is associated with good IVF outcome.
  • Endometrial perfusion (blood supply to the uterine lining) is an important factor in the process of implantation. The study found greater endometrial and subendometrial vascularisation following a series of acupuncture treatments leading to embryo transfer.
  • Acupuncture improved HOXA10 expression. Higher HOXA10 is associated with greater endometrial receptivity and good pregnancy outcomes. HOXA10 expression is lower in the uteri of women with hydrosalpinx, PCOS, and endometriosis.

How much acupuncture should you have to see those enhancements to your fertility? Women in this study had six acupuncture sessions per cycle for three menstrual cycles.

See the abstract of the study below. Read more

Stress reduces sperm quality, is acupuncture the answer?

Stress sperm acupunctureImpact of stress on female infertility and pregnancy has been well documented. Below study, published in journal of Fertility and Sterility, shows shows male reproductive health is similarly affected by it. The researchers are confident the correlation between stress and sperm parameters is clear.

Acupuncture has been shown to improve sperm quality, it has also been shown to help with stress. Researchers at the Georgetown University Medical Center have shown that acupuncture interferes with the very mechanism of stress.

Effects of work and life stress on semen quality

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Stress doubles the chance of infertility

stress-acupuncture-reproductionToo much stress is a serious factor affecting your fertility. The study published in the Journal of Human Reproduction found that stress can lead to two-fold increase in infertility among women trying to conceive for one year. Are you trying to conceive and are stressed? Perhaps it’s a good idea to consider acupuncture. It interferes with the very mechanism of stress.

Preconception stress increases the risk of infertility: results from a couple-based prospective cohort study—the LIFE study
C.D. Lynch1,*, R. Sundaram2, J.M. Maisog2, A.M. Sweeney3 and G.M. Buck Louis2
+ Author Affiliations Read more

Low uterine blood flow = no pregnancy

fertility and sterility acupuncture

Acupuncture has been shown to increase the uterine blood flow (decrease uterine blood impedance). But does the uterine blood flow really matter when you’re having an IVF? This study provides the answer. The researchers used special ultrasound technique to measure uterine blood flow. They found that it had an immense effect on both pregnancy and implantation rates. IVF with women, who had the lowest blood flow (PI>3) on the day of transfer, unfortunately didn’t result in any pregnancies.

Fertil Steril. 1992 Feb;57(2):372-6. Read more

Acupuncture – effective treatment for CPID Chronic Pelvic Inflammatory Disease

Yet another study shows that acupuncture does quite a bit more in the abdominal cavity than just increasing the blood flow to ovaries and uterus. Obviously, the study doesn’t directly link with treatment of infertility, but the promise is there.

Zhen Ci Yan Jiu. 2014 Apr;39(2):156-63.
[A meta-analysis on effectiveness of acupuncture and moxibustion for chronic pelvic inflammatory disease].
Fan LL, Yu WH, Liu XQ, Cui Z, Ma J, Li CP.
Abstract
OBJECTIVE:
To evaluate the clinical effect of acupuncture and moxibustion therapies for chronic pelvic inflammatory disease (CPID) by Meta-analysis.
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Embryo implantation failure – acupuncture increases number of implanted embryos

embryo-implantationSuccessful implantation is an absolute prerequisite for a successful pregnancy. The process by which a blastocyst is accepted by endometrium is involved and requires interplay of many systems.

The researchers of this study have discovered acupuncture can optimise this subtle uterine environment by modulating cytokines; and therefore it can increase the implantation rate.

Abstract:

J Huazhong Univ Sci Technolog Med Sci. 2014 Feb;34(1):91-8. doi: 10.1007/s11596-014-1237-9. Epub 2014 Feb 6.
Effect of acupuncture on CXCL8 receptors in rats suffering from embryo implantation failure.
Author information: Gao WN1, Yang W, Liu YF, Tang X, Guo Y, Wang LJ, Zhang MM, Huang GY.
Institute of Integrated Traditional Chinese Medicine and Western Medicine, Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

To observe the effect of acupuncture on CXCL8 receptors (CXCR1 and CXCR2) in rat endometrium experiencing embryo implantation failure, 72 pregnant rats were randomly divided into four groups: normal group (N), embryo implantation failure group (M), acupuncture treatment group (A), and progestin treatment group (W). Then the rats in each group were equally randomized into a day-6 (D6) group, a day-8 (D8) group, and a day-10 (D10) group. The rats in group M, group A, and group W were treated with mifepristone-sesame oil solution on day 1, while the rats in group N were injected with the same amount of sesame oil. Meanwhile, “Housanli” and “Sanyinjiao” were selected for acupuncture. From day 1 to the time of death, the rats in group A were fastened up and then acupuncture was administered while the rats in group N and group M were only fixed, and the rats in group W were given progestin. The number of implanted embryos was calculated. The expression of CXCR1 and CXCR2 in rat endometrium was detected by immunohistochemistry, Western blotting and real-time PCR. Compared to group N, the average number of implanted embryos, the protein and mRNA expression of CXCR1 (D6, D8 and D10), and the protein and mRNA expression of CXCR2 (D8 and D10) in rat endometrium were significantly decreased in group M. Compared to group M, there was significant elevation in the average number of implanted embryos, the protein expression (D6, D8 and D10) and mRNA expression (D8) of CXCR1 in rat endometrium of group A, and the protein expression (D8 and D10) and mRNA expression (D8) of CXCR2 in rat endometrium of group W. These findings indicated that acupuncture can increase the number of implanted embryos in rats of embryo implantation failure, which may be relevant with up-regulation the expression of CXCR1 and CXCR2 at maternal-fetal interface of rats with embryo implantation failure.

Acupuncture more effective than clomophene in treatment of pcos

clomophene pcos acupunctureThis study by Beijing Hospital of Obstetrics and Gynecology has shown acupuncture to be superior to clomophene on ovulation and pregnancy rates in treatment of polycystic ovary syndrome.

Other studies have shown that unlike Clomophene, acupuncture can have long term effect on PCOS by reducing the sympathetic nervous tonus. Apart from study methodology issues, another limitation of this study is that it only looked into the short term effect, but didn’t evaluate the effectiveness over a longer term. However, this is another study adding to the body of evidence. The study was published in the journal of Zhongguo Zhen jiu (Chinese Journal of Acupuncture & Moxibustion [2013, 33(11):961-964]).

Efficacy and safety evaluation of acupuncture combined with auricular acupoint therapy in the treatment of polycystic ovary syndrome

Department of Acupuncture and Physical Therapy, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China. geyongchun1981@sina.com
Zhongguo Zhen jiu = Chinese Acupuncture & Moxibustion [2013, 33(11):961-964]
Type: Journal Article, English Abstract (lang: chi)

OBJECTIVE: To compare the efficacy differences between acupuncture combined with auricular acupoint therapy and clomiphene oral administration in the treatment of polycystic ovary syndrome (PCOS).

METHODS: One hundred cases of PCOS were randomized into two groups, 50 cases in each one. Acupuncture combined with auricular acupuncture group (group A): acupuncture was applied at Guanyuan (CV 4), Zhongji (CV 3) and Zigong (EX-CA 1), once daily; auricular point sticking was applied at Spleen (pi, CO13), Endocrine (neifenmi, CO18), Uterus and Kidney (shen, CO10), the plaster was changed once a week. Clomiphene group (group B): oral clomiphene was prescribed at the 5th day of the menstrual, for 5 consecutive days, totally 3 menstrual cycles was needed. The ovulation induction, pregnancy and menstruation resuming of patients in the two ‘ , The totally effective rate was 90.00% (45/50) in group A, which was group were observed and compared.

RESULTS: The totally effective rate was 90.0% (45/50) in group A, which was superior to 86.0% (43/50) in group B (P<0.05); the ovulation rate and pregnancy rate were 68.0% (34/50)and 64. 0% (32/50) in group A, which were superior to that of group B (all P<0. 05); the menstruation resuming rate was 94.00 (47/50) in group A, which was superior to 88.00 (44/50) in group B (P<0.05). No adverse effect was observed in group A, while in group B, varying degrees of nausea, vomiting, headache and dermatitis were observed in 29 cases, ovarian hyperstimulation syndrome (OHSS) like polycystic ovary was observed in 14 cases under the B ultrasound.CONCLUSION: Acupuncture combined with auricular acupoint therapy has a better effect than clomiphene in the treatment of PCOS without any adverse effects.

PCOS Acupuncture: the most comprehensive paper to date?

pcos-acupuncture-effectA very thourough, well refferenced study exploring the mechanism and effects of acupuncture on PCOS.

Evid Based Complement Alternat Med. 2013; 2013: 762615.
Published online Sep 2, 2013. doi: 10.1155/2013/762615
PMCID: PMC3773899
Polycystic Ovary Syndrome: Effect and Mechanisms of Acupuncture for Ovulation Induction
Julia Johansson 1 and Elisabet Stener-Victorin 1 , 2 ,*
Author information ? Article notes ? Copyright and License information ?
This article has been cited by other articles in PMC.

Abstract
Polycystic ovary syndrome (PCOS), the most common endocrine disorder among women of reproductive age, is characterized by the coexistence of hyperandrogenism, ovulatory dysfunction, and polycystic ovaries (PCO). PCOS also represents the largest part of female oligoovulatory infertility, and the management of ovulatory and menstrual dysfunction, comprises a third of the high costs of PCOS treatment. Current pharmacological and surgical treatments for reproductive symptoms are effective, however, associated with negative side effects, such as cardiovascular complications and multiple pregnancies. For menstrual irregularities and ovulation induction in women with PCOS, acupuncture has indicated beneficial effects. This review will focus on the results from randomized controlled acupuncture trials for regulation of menstrual dysfunction and for inducing ovulation in women with PCOS although there are uncontrolled trials with nonetheless interesting results. Animal experimental studies will be further discussed when they can provide a more mechanistic explanatory view.
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Acupuncture superior to Metformin for PCOS

acupuncture-pcosAcupuncture showed considerable advantages over the metformin for obese PCOS patients. Acupuncture was shown to be more effective then metformin at improving menstrual freqency, reducing body mass index and waist to hip ratio. It also had fewer side-effects.

Effectiveness of Abdominal Acupuncture for Patients with Obesity-Type Polycystic Ovary Syndrome: A Randomized Controlled Trial
To cite this article:
Yan-Hua Zheng, Xin-Hua Wang, Mao-Hua Lai, Hong Yao, Hua Liu, and Hong-Xia Ma. The Journal of Alternative and Complementary Medicine. -Not available-, ahead of print. doi:10.1089/acm.2012.0429.

Online Ahead of Print: May 15, 2013 Read more

Acupuncture plus IVF = 5-fold increase in pregnancy rates (after two or more failed IVF cycles)

acupuncture-in-medicine-bmj

This study shows that there is a significant benefit to integrate acupuncture with IVF treatment for patients with two or more failed IVF cycles. It is one of the few studies using sham acupuncture to ensure that the effect of acupuncture is real, not just a placebo. The study was published in a reputable, pier-reviewed journal Acupuncture in Medicine, BMJ journals.

Influence of acupuncture on the outcomes of in vitro fertilisation when embryo implantation has failed: a prospective randomised controlled clinical trial.
IVF and acupuncture
Isoyama Manca di Villahermosa D, Dos Santos LG, Nogueira MB, Vilarino FL, Barbosa CP.
Source
Faculty of Medicine of ABC, Clinic for Human Reproduction, , Santo André, São Paulo, Brazil.
Abstract
OBJECTIVE:
To evaluate the effectiveness of acupuncture and moxibustion as an adjuvant treatment in women undergoing in vitro fertilisation (IVF) when embryo implantation has failed.
METHODS:
A prospective, randomised controlled clinical trial was conducted with 84 infertile patients who had had at least two unsuccessful attempts of IVF. The patients were randomised in three groups: control (n=28), sham (n=28) and acupuncture (n=28). The sample size was calculated by assuming a pregnancy rate of 10% when embryo implantation had failed. The pregnancy rates of the current IVF cycle were evaluated by measurement of blood beta human chorionic gonadotrophin (beta hCG) and subsequent transvaginal ultrasound. Acupuncture was performed on the first and seventh day of ovulation induction, on the day before ovarian puncture and on the day after embryo transfer. In the acupuncture group, patients were treated with moxibustion at nine acupuncture points (BL18, BL22, BL23, BL52, CV3, CV4, CV5, CV7, GV4) and needling at 12 points. In the sham group needles were inserted in eight areas that did not correspond to known acupuncture points.
RESULTS:
The clinical pregnancy rate in the acupuncture group was significantly higher than that in the control and sham groups (35.7% vs 7.1% vs 10.7%; p=0.0169).

CONCLUSIONS:
In this study, acupuncture and moxibustion increased pregnancy rates when used as an adjuvant treatment in women undergoing IVF, when embryo implantation had failed.

Acupuncture and Chinese herbal medicine in treatment of Endometriosis

This study demonstrates that acupuncture has a synergystic effect with Chinese Herbal medicine in treatment of Endometriosis. Furthermore the effect of acupuncture and herbal medicine was found to be superior to a pharmaceutical medicine Danazol. The abstract of the study is below.
Acupuncture Chinese medicine Endometriosis

Acupuncture enhances the effects of Chinese herbal Medicine in treatment of Endometriosis

J. Shi, Z. B. Z. Ge*
, Y. Jin,Y. D. Li and J. Zhou** The 1st Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, Zhejiang, China
*Sir Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, 310016, Zhejiang, China
**College of Food Science and Biotechnology, Zhejiang Gongshang University, Hangzhou, Zhejiang, 310012, China. Corresponding Author Email: juezhou2006@yahoo.com.cn

ABSTRACT

The present study was aimed to investigate whether acupuncture could significantly enhance the efficacy of Chinese herbal medicine (CHM) in treating endometriosis model rats. A total of 40 female Sprague-Dawley (SD) rats with body weight of 200 ±20 g were included. Operational transplantation was used with animal models. The rats were randomly divided into 5 groups: sham-operation control group (Group A), model group (Group B), CHM combined with acupuncture group (Group C), CHM group (Group D), Danazol group (Group E) with 8 rats in each group. During the treatment, two rats in Group B and one rat in Group E passed away. When the treatment ended, all the left rats were sacrificed. The samples of peritoneal fluids, serum and the ectopic endometrium were taken. The serum levels of cancer antigen 125 (CA-125) and interleukin 18(IL-18) in the peritoneal fluids were detected using enzyme-linked immune-sorbent assay. The cyclooxygenase-2 (COX-2) mRNA expression levels in the ectopic endometrium were measured by Real-time PCR. The results showed that in the rats from Groups A, C, D and E, the serum CA-125 levels, COX-2 mRNA expression in the ectopic endometrium and the IL-18 levels in the peritoneal fluids were significantly lower than those of Group B (P<0.05). The serum CA-125 levels and COX-2 mRNA expression in the ectopic endometrium of the rats in Group C were significantly lower than those of Group D (P<0.05), while there was no significant difference between Group C and E (P>0.05). The levels of IL-18 in the peritoneal fluids of the rats in Group C were markedly lower than those of Group D and E (P<0.05). It is then concluded that acupuncture treatment can improve the effects of CHM in treating endometriosis model rats. Key words: Chinese herbal medicine acupuncture; endometriosisReference: The Journal of Animal & Plant Sciences, 23(1): 2013, Page: 298-303 ISSN: 1018-7081

You can find a copy of the study here.

Study: Herbal formula helps oligoasthenospermia

Zhonghua Nan Ke Xue. 2012 Dec;18(12):1105-7.
[Compound Xuanju Capsule combined with vitamin E improves sperm chromatin integrity].
[Article in Chinese]
Song B1, He XJ, Jiang HH, Peng YW, Wu H, Cao YX.
Abstract
OBJECTIVE:
To investigate the clinical effects of the combined therapy of the Chinese medicine Compound Xuanju Capsule and vitamin E on sperm chromatin damage in idiopathic oligoasthenospermia.

METHODS:
We assigned 50 infertile men with seminal abnormality to a control group (n = 26) and a trial group (n = 24) to receive vitamin E and the combined therapy of Compound Xuanju Capsule plus vitamin E, respectively, both treated for 3 months. Before and after the treatment, we detected semen routine parameters and sperm DNA fragmentation indexes (DFI) by computer aided semen analysis (CASA) and sperm chromatin structure assay (SCSA), and compared them between the two groups.

RESULTS:
There was no obvious difference between the percentage of progressively motile sperm in the trial group and that in the control group (21.55 +/- 8.68 vs 21.47 +/- 11.53, P > 0.05). The trial group showed a significantly decreased sperm DFI after medication as compared with pre-medication (29.57 +/- 12.19 vs 34.09 +/- 10.32, P < 0.05).CONCLUSION: The combined therapy of Compound Xuanju Capsule and vitamin E can effectively improve seminal quality and reduce sperm chromatin damage in infertile men with idiopathic oligoasthenospermia.PMID: 23405792 [PubMed - indexed for MEDLINE]

Acupuncture during ovarian stimulation improves pregnancy outcomes in women undergoing IVF

This systematic review on Acupuncture and IVF is especially interesting. The studies of the well researched German protocol show acupuncture to be effective on the day of embryo replacement. This systematic review shows that acupuncture during ovarian stimulation also plays significant role in increasing the pregnancy outcomes of IVF.


The role of acupuncture in assisted reproductive technology.
Zheng CH, Zhang MM, Huang GY, Wang W.

Abstract
The aim of this paper was to provide reliable evidence by performing a systematic review and meta-analysis for evaluating the role of acupuncture in assisted reproductive technology. All randomized controlled trials that evaluated the effects of acupuncture, including manual, electrical, and laser acupuncture (LA) techniques, on the clinical pregnancy rate (CPR) and live birth rate (LBR) of in vitro fertilization (IVF) or artificial insemination were included. The controlled groups consisted of no acupuncture and sham acupuncture groups. The sham acupuncture included sham acupuncture at acupoints, sham acupuncture at non- or inappropriate points, sham LA, and adhesive tapes. Twenty-three trials (a total of 5598 participants) were included in this paper. The pooled CPR from all acupuncture groups was significantly higher than that from all controlled groups, whereas the LBR was not significantly different between the two groups. However, the results were quite distinct when the type of control and/or different acupuncture times were examined in a sensitivity analysis. The results mainly indicate that acupuncture, especially around the time of the controlled ovarian hyperstimulation, improves pregnancy outcomes in women undergoing IVF. More positive effects from acupuncture in IVF can be expected if a more individualized acupuncture programs are used.

Full text of the study can be found here.

Uterine blood flow and complications in pregnancy in women aged 35+

Advanced maternal age and increased risk of hypertensive disorders, a small-for-gestational-age infant and gestational diabetes? This study shows that it is all about the blood flow, not about age.

Early uterine artery Doppler velocimetry and the outcome of pregnancy in women aged 35 years and older

H. J. van den Elzen1, T. E. Cohen-Overbeek1, D. E. Grobbee2, R. W. P. Quartero1, Professor J. W. Wladimiroff1,*
Article first published online: 18 FEB 2003

DOI: 10.1046/j.1469-0705.1995.05050328.x

Keywords:
uterine artery;Doppler;pregnancy outcome;advanced age
Abstract
The objective of this paper was to determine whether first-and second-trimester uterine artery Doppler velocimetry are associated with pregnancy complications in women of advanced maternal age. A prospective cohort study of 352 women aged 35 years and older was studied. The pulsatility index (PI) values at 12–13 weeks of gestation were significantly associated with development of hypertensive disorders, a small-for-gestational-age infant and gestational diabetes, with a relative risk exceeding 4, 2 and 8, respectively for women with PI values in the highest quartile (> 1.67) of the PI distribution when compared with the lowest quartile of the PI distribution (< 1.24). At 23–27 weeks' gestation, uterine artery PI values were found to be associated with preterm delivery with a gestational age-adjusted risk of 10.6 for women with PI values in the highest quartile of PI (> 1.24) when compared with PI values in the lowest quartile of the PI distribution (< 1.09). No associations existed between uterine artery PI, antepartum hemorrhage and Cesarean section rate.The risk estimates for any of the outcome parameters were not affected by maternal age.Results indicate that hemodynamic changes detectable in the uterine artery as early as the first trimester of pregnancy are associated with an increased risk of hypertensive disorders, a small-for-gestational-age infant and gestational diabetes. A similar association exists in the late second trimester of pregnancy, with an increased risk of preterm delivery.