Acupuncture and good prognosis IVF patients

Acupuncture and good prognosis IVF patients: Synergy.

P. C. Magarelli, D. K. Cridennda, M. Cohen. Reproductive Medicine & Fertility Center, Colorado Springs, CO; East Winds Acupuncture, Inc., Colorado Springs, CO.

OBJECTIVE: To determine the role of electro stimulation acupuncture and traditional combined with auricular acupuncture on IVF outcomes in good prognosis patients.
Read more

Acupuncture & IVF Poor Responders: A Cure?

P.C. Magarelli, D.K. Cridennda. Reproductive Medicine & Fertility Center, Colorado Springs, CO.

Background and Significance: The utility of acupuncture in the treatment of infertility has been demonstrated in two controlled studies. The first study determined the effect of reducing the Pulsatility Index (PI) of the uterine artery on reproductive outcomes; the second study described a Pre/Post embryo transfer protocol that enhanced overall pregnancy rates (PR). There are no studies that have utilized both techniques.

Objective: The purpose of the study was to determine the influence of these two acupuncture protocols on IVF outcomes and secondly to identify the appropriate patient groups that would most benefit from this adjunctive therapy.
Read more

A preliminary immunopharmacological study of an antiendometriotic herbal medicine, Keishi-bukuryo-gan

Tanaka T; Mizuno K; Umesaki N; Ogita S Department of Obstetrics & Gynecology, Osaka City University Medical School, Japan.Osaka City Med J, 44(1):117-24 1998 Jun (ISSN: 0030-6096)

Changes in the specific antiendometrial IgM antibodies in an endometriotic patient, who were treated with leuproride acetate and in turn with Keishi-bukuyogan, were investigated by the flowcytometric analysis which was developed in our laboratory. The oriental therapy decreased the specific IgM antibody titer gradually and kept the patient symptom-free for more than 7 months without any suppression of serum CA125 and estradiol levels. On the other hand, leuproride acetate therapy suppressed both serum CA125 and serum estradiol levels but not the IgM antibody titer. The results suggest that the specific antiendometrial IgM autoantibody could be a pathogenic molecule in endometriosis and it could also serve as a clinical marker for the oriental therapy of endometriosis.

Male infertility: acupuncture and herbs regulate antisperm antiboy antisperm antibody (AsAb)

Effects of the combined therapy of acupuncture with herbal drugs on male immune infertility–a clinical report of 50 cases.
Fu B, Lun X, Gong Y.

Department of Acupuncture, Second Guangdong Provincial Worker’s Hospital, Guangzhou 510720, China.

To study the clinical effects of the combined therapy of acupuncture with herbal drugs on male immune infertility and on antisperm antibody (AsAb), 100 male cases of infertility with positive AsAb were divided randomly into two groups, each consisting of 50 cases. The acupuncture-drug group was treated with acupuncture on Ganshu (BL 18), Shenshu (BL 23), Taichong (LR 3), Taixi (KI 3), Xinshu (BL 15), Geshu (BL 17), Shenmen (HT 7), and Xuehai (SP 10), combined with oral medication of Liuwei Dihuang Wan (Bolus of the Six Drugs Including Rehmanniae). The control group was treated with oral prednisone. The clinical therapeutic effects and the impact on AsAb were observed in the two groups. The results showed that the total effective rate in the acupuncture-drug group was 90%; while that of the control group was 64%, the comparison showing a statistically significant difference (P<0.05). The positive rate of blood serum and/or AsAb in both the two groups decreased in varying degrees, but the negative-turning rate of AsAb in the acupuncture-drug group was more obvious, the comparison showing also a significant difference (P<0.05). CONCLUSION: The combined therapy of acupuncture with herbal drugs has definite therapeutic effects on male immune infertility, which can regulate AsAb and raise the immunity of the patients.

J Tradit Chin Med. 2005 Sep;25(3):186-9.

Acupuncture prior to and at IVF embryo transfer

Acupunct Med. 2006 Mar;24(1):23-8.

Acupuncture prior to and at embryo transfer in an assisted conception unit–a case series.
Johnson D.

Chobham Acupuncture Clinic, Chobham, Surrey. info@acupuncture-chobham.co.uk

Over a period of three years, acupuncture was offered to patients entering assisted reproduction therapy. Acupuncture sessions were given at varying, but usually weekly, intervals during the in vitro fertilisation (IVF) cycle, and immediately before and after embryo transfer. Twenty two patients (average age 36.2 years) were treated over a total of 26 IVF cycles and 15 pregnancies were achieved, as determined by presence of foetal heartbeat on ultrasound at four weeks post embryo transfer. This was a success rate of 57.7% compared with 45.3% for patients in the IVF unit not treated with acupuncture (P > 0.05). Relaxing effects were noted following acupuncture and it is speculated that this may have contributed to the increase in pregnancy rate for the acupuncture group.

Auricular acupuncture in the treatment of female infertility

Auricular acupuncture in the treatment of female infertility

Gerhard I; Postneek F Department of Gynecological Endocrinology and Reproduction, Women’s Hospital, University of Heidelberg, Germany.

Gynecol Endocrinol 1992 Sep;6(3):171-81 (ISSN: 0951-3590)

Following a complete gynecologic–endocrinologic workup, 45 infertile women suffering from oligoamenorrhea (n = 27) or luteal insufficiency (n = 18) were treated with auricular acupuncture. Results were compared to those of 45 women who received hormone treatment. Both groups were matched for age, duration of infertility, body mass index, previous pregnancies, menstrual cycle and tubal patency. Women treated with acupuncture had 22 pregnancies, 11 after acupuncture, four spontaneously, and seven after appropriate medication. Women treated with hormones had 20 pregnancies, five spontaneously, and 15 in response to therapy. Four women of each group had abortions. endometriosis (normal menstrual cycles) was seen in 35% (38%) of the women of each group who failed to respond to therapy with pregnancy. Only 4% of the women who responded to acupuncture or hormone treatment with a pregnancy had endometriosis, and 7% had normal cycles. In addition, women who continued to be infertile after hormone therapy had higher body mass indices and testosterone values than the therapy responders from this group. Women who became pregnant after acupuncture suffered more often from menstrual abnormalities and luteal insufficiency with lower estrogen, thyrotropin (TSH) and dehydroepiandrosterone sulfate (DHEAS) concentrations than the women who achieved pregnancy after hormone treatment. Although the pregnancy rate was similar for both groups, eumenorrheic women treated with acupuncture had adnexitis, endometriosis, out-of-phase endometria and reduced postcoital tests more often than those receiving hormones. Twelve of the 27 women (44%) with menstrual irregularities remained infertile after therapy with acupuncture compared to 15 of the 27 (56%) controls treated with hormones, even though hormone disorders were more pronounced in the acupuncture group. Side-effects were observed only during hormone treatment. Various disorders of the autonomic nervous system normalized during acupuncture. Based on our data, auricular acupuncture seems to offer a valuable alternative therapy for female infertility due to hormone disorders.

Acupuncture and ART

Controlled trial of acupuncture effects in assisted reproduction therapy
Paulus W.E.1, Zhang M.2, Strehler E.1, Seybold B.1 and Sterzik K.Christian-Lauritzen-Institut, Reproductive Medicine, Ulm, Germany and 2Tongji Medical University, Department of Traditional Chinese Medicine, Wuhan, China

Introduction: In a former published prospective randomized study we demonstrated the benefitt of acupuncture on the pregnancy rate in assisted reproduction therapy by comparing a group of patients receiving acupuncture treatment shortly before and after embryo transfer, with a control group receiving no acupuncture. To rule out the possibility that acupuncture produces only psychological or psychosomatic effects, we used a placebo needle set as a control in the present study.

Materials and Methods:Two hundred patients undergoing ICSI or IVF in our fertility centre were included in this prospective, randomized, placebo controlled trial. Only patients with good embryo quality were admitted. They were divided into two groups by random selection: embryo transfer with verum acupuncture (n = 100) and embryo transfer with placebo needling (n = 100). Verum acupuncture was performed in 100 patients 25 min before and after embryo transfer. In the control group (n = 100) a placebo needle set was used without penetrating the skin, but at the same acupoints and after the same scheme. Before embryo transfer we used the following locations: Cx6 (Neiguan), Sp8 (Diji), Liv3 (Taichong), Gv20 (Baihui) and S29 ( Guilai). After embryo transfer, the sterile disposable stainless steel needles (0.25 3 25 mm) were inserted at the following points: S36 (Zusanli), Sp6 (Sanyinjiao), Sp10 (Xuehai) and Li4 (Hegu). After 10 min the needles were rotated. The main outcome measure was clinical pregnancy defined by the presence of a fetal sac at ultrasound examination 6 weeks after embryo transfer. The Chi-squared test was used for comparison of both groups.

Results: Clinical pregnancies were documented in 43 of 100 patients (43.0%) in the acupuncture group, whereas pregnancy rate reached 37.0% (37 out of 100 patients) in the control group. A significant difference between verum acupuncture and placebo needling could not be demonstrated (P = 0.39).

Conclusion:The missing advantage of verum acupuncture versus placebo needling may be due to the methodical problem that real placebo models for acupuncture are lacking. Our placebo needle set induces an acupressure effect thus leading to a higher pregnancy rate than in our population without any complementary treatment.

Acupuncture and IVF embryo transfer, ART and PCOS

Acupunct Med. 2006 Dec;24(4):157-63.

Use of acupuncture in female infertility and a summary of recent acupuncture studies related to embryo transfer.

Stener-Victorin E, Humaidan P.

Institute of Neuroscience and Physiolopgy, Sahlgrenska Academy, Goteborg University, Sweden. elisabet.stener-victorin@neuro.gu.se

During the last five years the use of acupuncture in female infertility as an adjuvant to conventional treatment in assisted reproductive technology (ART) has increased in popularity. The present paper briefly discusses clinical and experimental data on the effect of acupuncture on uterine and ovarian blood flow, as an analgesic method during ART, and on endocrine and metabolic disturbances such as polycystic ovary syndrome (PCOS). Further it gives a summary of recent studies evaluating the effect of acupuncture before and after embryo transfer on pregnancy outcome. Of the four published RCTs, three reveal significantly higher pregnancy rates in the acupuncture groups compared with the control groups. But the use of different study protocols makes it difficult to draw definitive conclusions. It seems, however, that acupuncture has a positive effect and no adverse effects on pregnancy outcome.

Effects of ferulic acid on fertile and asthenozoospermic infertile human sperm motility, viability, lipid peroxidation, and cyclic nucleotides.

Effects of ferulic acid on fertile and asthenozoospermic infertile human sperm motility, viability, lipid peroxidation, and cyclic nucleotides.

Zheng RL, Zhang H.

Department of Biology, Lanzhou University, P.R. China.

The capacity of human sperm fertilization principally depends on sperm motility and membrane integrity. Reactive oxygen species, such as superoxide anion and hydrogen peroxide, are known to impair sperm motility and membrane integrity by inducing membrane lipid peroxidation (LPO). Ferulic acid (FA), an effective constituent in various medicinal herbs, has recently been shown to scavenge oxygen free radicals and increase the intracellular cAMP and cGMP. The aim of this study is to investigate the effects of FA on human sperm motility, viability, lipid peroxidation, and cyclic nucleotides in fertile and asthenozoospermic infertile individuals in vitro. The sperm samples were obtained from 10 fertile volunteers and 10 asthenozoospermic infertile patients. Washed spermatozoa were incubated at 37 degrees C in Ham’s F-10 medium with 0, 0.1, 0.2, 0.4, 0.8, or 1.6 mM of FA. Samples were analyzed for viability, determined by eosin-Y dye exclusion method at 0, 1, 2, 3, 5, and 6 h of incubation; motility, determined by the trans-membrane migration method within 2 h of incubation; LPO, determined by thiobarbituric acid (TBA) method at 3 h of incubation and the intracellular cAMP and cGMP, determined, respectively, by 3H-cAMP and 125I-cGMP radioimmunoassay at 3 h of incubation. The results showed: in both fertile and infertile spermatozoa, the viability, trans-membrane migration ratio (TMMR) and the levels of intracellular cAMP and cGMP in FA-treated spermatozoa were significantly higher than those of spermatozoa in control groups, while TBA-reactive substances contents in treated spermatozoa were significantly lower than those in control spermatozoa. The effects of FA on these processes were concentration dependent. These data suggested that FA is beneficial to sperm viability and motility in both fertile and infertile individuals, and that reduction of lipid peroxidative damage to sperm membranes and increase of intracellular cAMP and cGMP may be involved in these benefits. It is possible that FA may be used for cure of asthenozoospermic infertility.

Free Radic Biol Med. 1997;22(4):581-6.

Combination of Chinese herbs and hormones could lower the NO (nitric oxide) level in semen and improve the quality of sperm

Clinical observation on effect of combination of zhuanyindan and hormone in treating male infertility with positive antisperm antibody
[Article in Chinese]
Yu AL, Zhang FZ, Zhang FX.

Taishan Medical College, Shandong 271000.

OBJECTIVE: To explore the therapeutic effect of combination of Zhuanyindan (ZYD, a Chinese herbal preparation) and hormone in treating male infertility with positive antisperm antibody and its influence on nitric oxide (NO) level. METHODS: Eighty-two patients were randomly divided (according to the digital list) into the WM group (n = 20, treated with prednisone), the TCM group (n = 28, treated with ZYD) and the ICWM group (n = 34, treated with prednisone plus ZYD). The clinical effect, negative converting rate of antisperm antibody, changes of NO level in semen and various parameters of sperm motion before and after treatment were observed. RESULTS: The total effective rate in the ICWM group was 88.2%, that in the TCM group 75.0% and in the WM group 65.0%. Significant difference was seen in the ICWM and TCM group before and after treatment in NO level, sperm motion parameters, including linear motion speed, linearity, propulsion, whip frequency, sperm vitality and mean moving angle, and quality of semen (P < 0.05 or P < 0.01). In the WM group, significant difference in comparison before and after treatment was seen in NO level, propulsion, whip frequency, mean moving angle and quality of semen, including vitality and survival rate (P < 0.01). CONCLUSION: Combination of Chinese herbs and hormone could lower the NO (nitric oxide) level in semen and improve the quality of sperm. Zhongguo Zhong Xi Yi Jie He Za Zhi. 2004 Mar;24(3):223-6.

Effects of Electro-Acupuncture on Nerve Growth Factor and Ovarian Morphology in Rats with Experimentally Induced Polycystic Ovaries

human-reproduction-infertility-acupuncture

Effects of Electro-Acupuncture on Nerve Growth Factor and Ovarian Morphology in Rats with Experimentally Induced Polycystic Ovaries

1

Elisabet Stener-Victorin

2,a, Thomas Lundebergb, Urban Waldenströma, Luigi Mannic, Luigi Aloec, Stefan Gunnarssond, and Per Olof Jansona

a Department of Obstetrics and Gynecology, Göteborg University, SE-413 45 Göteborg, Sweden b Department of Physiology and Pharmacology, Karolinska Institutet, SE-164 01 Stockholm, Sweden c Institute of Neurobiology (CNR), Rome, Italy d Department of Evolutionary Biology, SE-752 36 Uppsala, Sweden

ABSTRACT

Despite extensive research on the pathogenesis of polycystic ovary syndrome (PCOS), there is still disagreement on the underlying mechanisms. The rat model for experimentally induced polycystic ovaries (PCO)—produced by a single injection of estradiol valerate—has similarities with human PCOS, and both are associated with hyperactivity in the sympathetic nervous system. Nerve growth factor (NGF) is known to serve as a neurotrophin for both the sympathetic and the sensory nervous systems and to enhance the activity of catecholaminergic and possibly other neuron types. Electro-acupuncture (EA) is known to reduce hyperactivity in the sympathetic nervous system. For these reasons, the model was used in the present study to investigate the effects of EA (12 treatments, approximately 25 min each, over 30 days) by analyzing NGF in the central nervous system and the endocrine organs, including the ovaries. The main findings in the present study were first, that significantly higher concentrations of NGF were found in the ovaries and the adrenal glands in the rats in the PCO model than in the control rats that were only injected with the vehicle (oil or NaCl). Second, that repeated EA treatments in PCO rats resulted in concentrations of NGF in the ovaries that were significantly lower than those in non-EA-treated PCO rats but were within a normal range that did not differ from those in the untreated oil and NaCl control groups. The results in the present study provide support for the theory that EA inhibits hyperactivity in the sympathetic nervous system.

Read more

TCM herbs and miscarriage

herbs-miscarriage-acupunctureThis study confirmed Chinese herbal medicines can reduce the risk of miscarriage in the early weeks of pregnancy. Two days after embryo transfer a group of women was administered a Chinese herbal formula renown to reduce the risk of miscarriage. Control group were not administered any hers. But both groups were on progesterone support treatment.

Researchers found, that there was a significant reduction of miscarriages in the group taking Chinese herbal medicine. 23% of women in the progesterone only group miscarried, while in the Chinese herbs group this number was significantly lower – 13%.

The study was published in the Chinese Journal of Integrative Medicine.

Chin J Integr Med. 2006 Sep;12(3):189-93.
Effect of Gutai Decoction on the abortion [miscarriage] rate of in vitro fertilization and embryo transfer.
Liu Y1, Wu JZ.
Author information
Abstract
OBJECTIVE:
To study the effect of Chinese herbal medicine Gutai Decoction (GTD) on the abortion rate of in vitro fertilization and embryo transfer (IVF-ET).

METHODS:
Observed were two hundred and forty-seven women having received IVF-ET and with beta-human chorionic gonadotropin (beta-HCG) > 25 IU/L on the 14th day after transferring. All were treated conventionally with progesterone 20 – 80 mg per day after transferring and if necessary the treatment was supplemented with Progynova 2 – 4 mg per day, with the medication withdrawn gradually from the 9th week of pregnancy till stopped completely. Among them 131 cases received GTD medication additionally, for 109 cases of whom the medication started from the 2nd day of transferring (taken as Group A) and for the other 22 cases from the 14th day after transferring (taken as Group B), the other 116 cases with no additional GTD treatment given were taken as the control group, with the medication lasting to the 12th week. The abortion rate in them was observed.

RESULTS:
The abortion rate in Group A, Group B and the control group was 12.84%, 13.64% and 23.28%, respectively, the difference between the GTD treated groups and the control group was significant (P < 0.05). CONCLUSION: Chinese medicine GTD could reduce abortion rate in women receiving IVF-ET. PMID: 17005079 [PubMed - indexed for MEDLINE]

Stress hormone Cortisol and early miscarriage

Cortisol levels and very early pregnancy loss (miscarriage) in humans
Pablo A. Nepomnaschy , Kathleen B. Welch , Daniel S. McConnell, Bobbi S. Low, Beverly I. Strassmann , and Barry G. England

Author Affiliations
*Department of Anthropology, 1085 South University Avenue,
Reproductive Sciences Program, Department of Obstetrics and Gynecology, L4000 Women’s Hospital,
School of Natural Resources and Environment, 430 East University Street,
Center for Statistical Consultation and Research, 915 East Washington Street,
Department of Epidemiology, School of Public Health, 109 Observatory Street,
**Research Center for Group Dynamics, Institute for Social Research, 426 Thompson Street, and
††Department of Pathology, Medical Science I, 1301 Catherine Street, University of Michigan, Ann Arbor, MI 48109

Communicated by Richard D. Alexander, University of Michigan, Ann Arbor, MI, December 27, 2005 (received for review December 17, 2004)
Abstract

Maternal stress is commonly cited as an important risk factor for spontaneous abortion. For humans, however, there is little physiological evidence linking miscarriage to stress. This lack of evidence may be attributable to a paucity of research on maternal stress during the earliest gestational stages. Most human studies have focused on “clinical” pregnancy (>6 weeks after the last menstrual period). The majority of miscarriages, however, occur earlier, within the first 3 weeks after conception (?5 weeks after the last menstrual period). Studies focused on clinical pregnancy thus miss the most critical period for pregnancy continuance. We examined the association between miscarriage and levels of maternal urinary cortisol during the first 3 weeks after conception. Pregnancies characterized by increased maternal cortisol during this period (within participant analyses) were more likely to result in spontaneous abortion or miscarriage (P < 0.05). This evidence links increased levels in this stress marker with a higher risk of early pregnancy loss in humans.

Read more

Acupuncture increases percentage of normal sperm form

This study showed that acupuncture significantly improves sperm morphology (increases percentage of normal form sperm). This was a randomised controlled blinded trial and was published in a peer-reviewed Asian Journal of Andrology.

abnormal-sperm-acupuncture

Asian J Androl. 2003 Dec;5(4):345-8.
Effects of acupuncture and moxa treatment in patients with semen abnormalities.
Gurfinkel E, Cedenho AP, Yamamura Y, Srougi M.
Source
Human Reproduction Division, Discipline of Urology, São Paulo Federal University, Paulista School of Medicine, São Paulo, Brazil. egurfa@uol.com.br
Abstract
AIM:
To evaluate the effect of Chinese Traditional Medicine, acupuncture and moxa treatment, on the semen quality in patients with semen abnormalities.
METHODS:
In a prospective, controlled and blind study, nineteen patients, aged 24 years approximately 42 years and married for 3 years approximately 11 years without children with semen abnormalities in concentration, morphology and/or progressive motility without apparent cause, were randomized into two groups and submitted to acupuncture and moxa treatment at the therapeutic (Study Group) and the indifferent points (Control Group), respectively, for 10 weeks. Semen analyses were performed before and after the treatment course.
RESULTS:
The patients of the Study Group presented a significant increase in the percentage of normal-form sperm compared to the Control Group (calculated U=16.0, critical U=17.0).
CONCLUSION:
The Chinese Traditional Medicine acupuncture and moxa techniques significantly increase the percentage of normal-form sperm in infertile patients with oligoastenoteratozoospermia without apparent cause.

Acupuncture helps patients with very poor sperm density

Acupuncture is effective for men with very poor sperm density. With these men acupuncture can improve sperm quality to the extent that they don’t have to undergo testicular biopsy. The abstract of the study:

Does acupuncture treatment affect sperm density in males with very low sperm count? A pilot study.
Siterman S, Eltes F, Wolfson V, Lederman H, Bartoov B.
Source
Institute of Chinese Medicine, Tel Aviv, Israel.
Abstract
Classic therapies are usually ineffective in the treatment of patients with very poor sperm density. The aim of this study was to determine the effect of acupuncture on these males. Semen samples of 20 patients with a history of azoospermia were examined by light microscope (LM) and scanning electron microscope (SEM), with which a microsearch for spermatozoa was carried out. These examinations were performed before and 1 month after acupuncture treatment and revealed that the study group originally contained three severely oligoteratoasthenozoospermic (OTA), two pseudoazoospermic and 15 azoospermic patients. The control group was comprised of 20 untreated males who underwent two semen examinations within a period of 2-4 months and had initial andrological profiles similar to those of the experimental group. No changes in any of the parameters examined were observed in the control group. There was a marked but not significant improvement in the sperm counts of severely OTA males following acupuncture treatment (average = 0.7 +/- 1.1 x 10(6) spermatozoa per ejaculate before treatment vs. 4.3 +/- 3.2 x 10(6) spermatozoa per ejaculate after treatment). A definite increase in sperm count was detected in the ejaculates of 10 (67%) of the 15 azoospermic patients. Seven of these males exhibited post-treatment spermatozoa that were detected even by LM. The sperm production of these seven males increased significantly, from 0 to an average of 1.5 +/- 2.4 x 10(6) spermatozoa per ejaculate (Z = -2.8, P < or = 0.01). Males with genital tract inflammation exhibited the most remarkable improvement in sperm density (on average from 0.3 +/- 0.6 x 10(6) spermatozoa per ejaculate to 3.3 +/- 3.2 x 10(6) spermatozoa per ejaculate; Z = -2.4, P < or = 0.02). Two pregnancies were achieved by the IVF-ICSI procedure. It is concluded that acupuncture may be a useful, nontraumatic treatment for males with very poor sperm density, especially those with a history of genital tract inflammation.