Feb
1
New systematic review: Acupuncture improves Clinical Pregnancy Rates and Live Birth Rates among women undergoing IVF
Posted by admin in acupuncture, female infertility, infertility, IVF
Fertil Steril. 2012 Jan 11
Effects of acupuncture on pregnancy rates in women undergoing in vitro fertilization: a systematic review and meta-analysis.
Zheng CH, Huang GY, Zhang MM, Wang W.
Source
Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People’s Republic of China.
Abstract
OBJECTIVE:
To evaluate the effect of acupuncture on in vitro fertilization (IVF) outcomes.
DESIGN:
Systematic review and meta-analysis.
PATIENT(S):
Women undergoing IVF in randomized controlled trials (RCTs) who were evaluated for the effects of acupuncture on IVF outcomes.
SETTING:
Not applicable.
INTERVENTION(S):
The intervention groups used manual, electrical, and laser acupuncture techniques. The control groups consisted of no, sham, and placebo acupuncture.
MAIN OUTCOME MEASURE(S):
The major outcomes were clinical pregnancy rate (CPR) and live birth rate (LBR). Heterogeneity of the therapeutic effect was evaluated with a forest plot analysis. Publication bias was assessed by a funnel plot analysis.
RESULT(S):
Twenty-four trials (a total of 5,807 participants) were included in this review. There were no significant publication biases for most of the comparisons among these studies. The pooled CPR (23 studies) from all of the acupuncture groups was significantly greater than that from all of the control groups, whereas the LBR (6 studies) was not significantly different between the two groups. The results were different when the type of control was examined in a sensitivity analysis. The CPR and LBR differences between the acupuncture and control groups were more obvious when the studies using the Streitberger control were ignored. Similarly, if the underlying effects of the Streitberger control were excluded, the LBR results tended to be significant when the acupuncture was performed around the time of oocyte aspiration or controlled ovarian hyperstimulation.
CONCLUSION(S):
Acupuncture improves CPR and LBR among women undergoing IVF based on the results of studies that do not include the Streitberger control. The Streitberger control may not be an inactive control. More positive effects from using acupuncture in IVF can be expected if an appropriate control and more reasonable acupuncture programs are used.
Sep
28
New Study: Electro-acupuncture increases IVF success rate
Posted by admin in acupuncture, infertility, IVF
Increase of success rate for women undergoing embryo transfer by transcutaneous electrical acupoint stimulation: a prospective randomized placebo-controlled study
Objective
To evaluate the effect of transcutaneous electrical acupoint stimulation (TEAS) on pregnancy rates (PR) in women undergoing ET.
Design
Prospective, randomized, single-blinded placebo-controlled clinical trial.
Setting
Research and laboratory facilities.
Patient(s)
A total of 309 patients, less than 45 years old, undergoing cryopreservation embryos transplant or fresh cycle IVF with or without intracytoplasmic sperm injection (ICSI).
Intervention(s)
The subjects were randomly allocated to three groups: mock TEAS treatment: 30 minutes after ET (group I, n = 99); single TEAS treatment: 30 minutes after ET (group II, n = 110); and double TEAS treatments: 24 hours before ET and 30 minutes after ET (group III, n = 100).
Main Outcome Measure(s)
Clinical PR, embryos implantation rate, live birth rate.
Result(s)
The clinical PR, embryos implantation rate, and live birth rate of group I (29.3%, 15.0%, and 21.2%, respectively) were significantly lower than those in group II (42.7%, 25.7%, and 37.3%, respectively) and group III (50.0%, 25.9%, and 42.0%, respectively).
Conclusion(s)
Transcutaneous electrical acupoint stimulation, especially double TEAS, significantly improved the clinical outcome of ET.
Key Words: Acupuncture, transcutaneous electrical acupoint stimulation (TEAS), pregnancy rate (PR), in vitro fertilization (IVF), embryo transfer (ET), intracytoplasmic sperm injection (ICSI)
May
26
In studies acupuncture plus IVF, the outcome is pregnancy, which is entirely objective and unlikely to be affected by a patient’s expectations
Posted by admin in acupuncture, IVF
Selecting a control for in vitro fertilization and acupuncture randomized controlled trials (RCTs): how sham controls may unnecessarily complicate the RCT evidence base
Eric Manheimer M.S.Corresponding Author Contact Information, a, E-mail The Corresponding Author
a Center for Integrative Medicine, School of Medicine, University of Maryland, Baltimore, Maryland
Received 5 April 2011;
revised 11 April 2011;
accepted 13 April 2011.
Available online 13 May 2011.
Objective
To examine the theoretical and methodologic rationales for the use of sham acupuncture controls in trials of adjuvant acupuncture for in vitro fertilization (IVF), and to identify the drawbacks of using a sham acupuncture control that may have its own effects on the pregnancy outcome. More »
Aug
19
Poor ovarian reserve and acupuncture
Posted by admin in acupuncture, female infertility, IVF
Zhongguo Zhen Jiu. 2009 Oct;29(10):775-9.
[Effects of electro-acupuncture on in vitro fertilization-embryo transfer (IVF-ET) of patients with poor ovarian response]
[Article in Chinese]
Chen J, Liu LL, Cui W, Sun W.
Department of Reproduction, The Second Affiliated Hospital of Shandong University of TCM, Jinan 250001, China. fusantai@126.com
Abstract
OBJECTIVE: To observe the effect of electro-acupuncture therapy on oocyte quality and pregnancy outcome of patients with poor ovarian response or decreased reserve in the course of in vitro fertilization (IVF).
METHODS: Sixty cases accepting IVF-ET were randomly divided into an observation group and a control group, 30 cases in each group. The two groups were both treated with antagonist scheme for ovulation induction, and the electro-acupuncture intervention was also added in the observation group, Guanyuan (CV 4), Taixi (KI 3), Sanyinjiao (SP 6) etc. were selected. The therapeutic effects in the two groups were compared after treatment.
RESULTS: There was no significant difference between the two groups before treatment. The symptoms of kidney difficiency in the observation group were significantly improved after treatment, and the levels of serum estradiol (E2), fertilization rate, oocyte maturation rate, good quality embryos rate, and implantation rate in the observation group were superior to those in the control group on human Chorionic Gonadotropin (hCG) injection day (all P<0.05); the levels of stem cell factor (SCF) in follicular fluid and serum in the observation group were significantly higher than those in the control group (both P<0.05). The pregnancy rate in the observation group was higher than that in the control group, and the abortion rate in the observation group was lower than that in the control group, but there was no significant difference between the two groups (both P>0.05).
CONCLUSION: Electro-acupuncture therapy has a good clinical effect for IVF patients with poor ovarian reserve, and can improve oocyte (egg) quality and pregnancy outcome.
PMID: 19873910 [PubMed - indexed for MEDLINE]
Aug
19
IVF + Acupuncture = lower stress, higher pregnancy rate
Posted by admin in acupuncture, IVF
Complement Ther Clin Pract. 2010 Aug;16(3):154-7. Epub 2009 Dec 24.
The relationship between perceived stress, acupuncture, and pregnancy rates among IVF patients: a pilot study.
Balk J, Catov J, Horn B, Gecsi K, Wakim A.
University of Pittsburgh, Magee-Womens Hospital, 300 Halket Street, Pittsburgh, PA 15213, USA. jbalk@magee.edu
Abstract
The aim of this paper was to determine the effect of acupuncture on perceived stress levels in women on the day of embryo transfer (ET), and to determine if perceived stress levels at embryo transfer correlated with pregnancy rates. The study was an observational, prospective, cohort study based at the University IVF center.
PATIENT(S): 57 infertile patients undergoing IVF or IVF/ICSI. INTERVENTIONS(S): Patients were undergoing Embryo Transfer with or without acupuncture as part of their standard clinical care.
MAIN OUTCOME MEASURE(S): Perceive Stress Scale scores, pregnancy rates.
RESULT(S): women who received this acupuncture regimen achieved pregnancy 64.7%, whereas those without acupuncture achieved pregnancy 42.5%. When stratified by donor recipient status, only non-donor recipients potentially had an improvement with acupuncture (35.5% without acupuncture vs. 55.6% with acupuncture). Those who received this acupuncture regimen had lower stress scores both pre-ET and post-ET compared to those who did not. Those with decreased their perceived stress scores compared to baseline had higher pregnancy rates than those who did not demonstrate this decrease, regardless of acupuncture status. CONCLUSIONS(S): 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.
PMID: 20621276 [PubMed - in process]PMCID: PMC2904299 [Available on 2011/8/1]
Apr
21
Acupuncture benefits cortisol and prolactin levels in IVF patients
Posted by admin in acupuncture, IVF
Changes in serum cortisol and prolactin associated with acupuncture during controlled ovarian hyperstimulation in women undergoing in vitro fertilization–embryo transfer treatment
Paul C. Magarelli, M.D.aCorresponding Author Informationemail address, Diane K. Cridennda, L.Acb, Mel Cohen, Ph.D.a
Received 22 May 2008; received in revised form 24 October 2008; accepted 28 October 2008. published online 31 December 2008.
Corrected Proof
Objective
To determine whether changes in serum cortisol (CORT) and PRL are affected by acupuncture (Ac) in Ac-treated IVF patients.
Design
Prospective cohort clinical study.
Setting
Private practice reproductive endocrinology and infertility clinic and private practice acupuncture consortium.
Patient(s)
Sixty-seven reproductive-age infertile women undergoing IVF.
Intervention(s)
Blood samples were obtained from all consenting new infertility patients and serum CORT and serum PRL were obtained prospectively. Patients were grouped as controls (IVF with no Ac) and treated (IVF with Ac) according to acupuncture protocols derived from randomized controlled trials.
Main Outcome Measure(s)
Serum levels of CORT and PRL were measured and synchronized with medication stimulation days of the IVF cycle (e.g., day 2 of stimulation, day 3, etc.). Reproductive outcomes were collected according to Society for Assisted Reproductive Technology protocols, and results were compared between controls and those patients treated with Ac.
Result(s)
CORT levels in Ac group were significantly higher on IVF medication days 7, 8, 9, 11, 12, and 13 compared with controls. PRL levels in the Ac group were significantly higher on IVF medication days 5, 6, 7, and 8 compared with controls.
Conclusion(s)
In this study, there appears to be a beneficial regulation of CORT and PRL in the Acupuncture group during the medication phase of the IVF treatment with a trend toward more normal fertile cycle dynamics.
Sep
24
Acupuncture for male and female infertility – systematic review
Posted by admin in acupuncture, ART, female infertility, infertility, IVF, male infertility, polycystic ovaries
The Role of Acupuncture in the Management of Subfertility
Ng E H et al Fertil Steril. 2008 Jul;90(1):1-13.
Fertility and Sterility
Abstract
OBJECTIVE: To review systematically the use of acupuncture in the management of subfertility.
DESIGN: A computer search was performed via several English and Chinese databases to identify journals relevant to the subject.
RESULT(S): The positive effect of acupuncture in the treatment of subfertility may be related to the central sympathetic inhibition by the endorphin system, the change in uterine blood flow and motility, and stress reduction. Acupuncture may help restore ovulation in patients with polycystic ovary syndrome, although there are not enough randomized studies to validate this.
There is also no sufficient evidence supporting the role of acupuncture in male subfertility, as most of the studies are uncontrolled case reports or case series in which the sample sizes were small. Despite these deficiencies, acupuncture can be considered as an effective alternative for pain relief during oocyte retrieval in patients who cannot tolerate side effects of conscious sedation.
The pregnancy rate of IVF treatment is significantly increased, especially when acupuncture is administered on the day of embryo transfer.
CONCLUSION(S): Although acupuncture has gained increasing popularity in the management of subfertility, its effectiveness has remained controversial.
Feb
10
Systematic review: Acupuncture and IVF: Acupuncture improves rates of pregnancy and live birth
Posted by admin in acupuncture, ART, Chinese herbs, Chinese medicine, female infertility, infertility, IVF, male infertility, polycystic ovaries, stress/anxiety
Effects of acupuncture on rates of pregnancy and live birth among women undergoing in vitro fertilisation: systematic review and meta-analysis
Eric Manheimer, research associate1, Grant Zhang, assistant professor1, Laurence Udoff, assistant professor2, Aviad Haramati, professor3, Patricia Langenberg, professor and vice-chair4, Brian M Berman, professor1, Lex M Bouter, professor and vice chancellor (rector magnificus)5
1 Center for Integrative Medicine, University of Maryland School of Medicine, 2200 Kernan Drive, Kernan Hospital Mansion, Baltimore, MD 21207, USA, 2 Department of Obstetrics, Gynecology and Reproductive Services, University of Maryland School of Medicine, 3 Department of Physiology and Biophysics and Medicine, Georgetown University School of Medicine, Washington, DC, 4 Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, 5 VU University Amsterdam De Boelelaan 1105, 1081 HV Amsterdam, the Netherlands
Correspondence to: E Manheimer emanheimer@compmed.umm.edu
Objective To evaluate whether acupuncture improves rates of pregnancy and live birth when used as an adjuvant treatment to embryo transfer in women undergoing in vitro fertilisation.
Design Systematic review and meta-analysis.
Data sources Medline, Cochrane Central, Embase, Chinese Biomedical Database, hand searched abstracts, and reference lists.
Review methods Eligible studies were randomised controlled trials that compared needle acupuncture administered within one day of embryo transfer with sham acupuncture or no adjuvant treatment, with reported outcomes of at least one of clinical pregnancy, ongoing pregnancy, or live birth. Two reviewers independently agreed on eligibility; assessed methodological quality; and extracted outcome data. For all trials, investigators contributed additional data not included in the original publication (such as live births). Meta-analyses included all randomised patients.
Data synthesis Seven trials with 1366 women undergoing in vitro fertilisation were included in the meta-analyses. There was little clinical heterogeneity. Trials with sham acupuncture and no adjuvant treatment as controls were pooled for the primary analysis. Complementing the embryo transfer process with acupuncture was associated with significant and clinically relevant improvements in clinical pregnancy (odds ratio 1.65, 95% confidence interval 1.27 to 2.14; number needed to treat (NNT) 10 (7 to 17); seven trials), ongoing pregnancy (1.87, 1.40 to 2.49; NNT 9 (6 to 15); five trials), and live birth (1.91, 1.39 to 2.64; NNT 9 (6 to 17); four trials). Because we were unable to obtain outcome data on live births for three of the included trials, the pooled odds ratio for clinical pregnancy more accurately represents the true combined effect from these trials rather than the odds ratio for live birth. The results were robust to sensitivity analyses on study validity variables. A prespecified subgroup analysis restricted to the three trials with the higher rates of clinical pregnancy in the control group, however, suggested a smaller non-significant benefit of acupuncture (odds ratio 1.24, 0.86 to 1.77).
Conclusions Current preliminary evidence suggests that acupuncture given with embryo transfer improves rates of pregnancy and live birth among women undergoing in vitro fertilisation.
Jun
17
Acupuncture, IVF/ICSI and follicle development
Posted by admin in acupuncture, ART, female infertility, ICSI, IVF
Acupuncture Treatment For Infertile Women Undergoing Intracytoplasmic Sperm injection
Sandra L. Emmons, MD
Phillip Patton, MD
Source: Medical Acupuncture, A Journal For Physicians By Physicians
Spring / Summer 2000- Volume 12 / Number 2
"Aurum Nostrum Non Est Aurum Vulgi"
| Table 1. Outcomes for Acupuncture vs Non-Acupuncture Cycles Among 6 Women Undergoing ICSI* | ||||||
|
Patient No.
|
Age, y
|
Non-Acupuncture Cycles
|
AcupunctureCycles
|
|||
| Follicles | Cycles | Follicles | Cycles | |||
| Mean No. | No. | Mean No. | No. | Outcome | ||
| 1 | 29 | 4.7 | 3 | 8 | 1 | IUP |
| 2 | 34 | 2 | 1 | 10 | 2 | SAB twice |
| 3 | 36 | 3 | 2 | 14 | 1 | SAB |
| 4 | 37 | 8 | 1 | 6 | 1 | No pregnancy |
| 5 | 38 | 1 | 1 | 4 | 1 | Cycle canceled |
| 6 | 41 | 2 | 1 | 6 | 1 | SAB |
| Mean (SD) | 3.7 (1.0) | 8.4 (1.3) | ||||
| *ICSI indicates intracytoplasmic sperm injection; IUP, intrauterine pregnancy; and SAB, early spontaneous abortion. P=.02 for overall acupuncture follicles vs non-acupuncture follicles. | ||||||
May
22
Acupuncture pain relief egg retrieval means good pain relief, higher implantation rate, higher pregnancy rate, and take home baby rate
Posted by admin in acupuncture, ART, IVF
A prospective randomized study of electro-acupuncture versus alfentanil as anaesthesia during oocyte aspiration in in-vitro fertilization
Elisabet Stener-Victorin1,4, Urban Waldenström2, Lars Nilsson1, Matts Wikland3 and Per Olof Janson1
1 Department of Obstetrics and Gynaecology, Göteborg University, SE-413 45 Göteborg, 2 IVF Center Falun, SE-791 82 Fallun, 3 Fertility Centre Scandinavia, SE-402 29 Göteborg, Sweden
The aim of the present study was to evaluate the anaesthetic effect during oocyte aspiration of a paracervical block (PCB) in combination with either electro-acupuncture (EA) or intravenous alfentanil. In all, 150 women undergoing in-vitro fertilization (IVF) and embryo transfer were randomized to receive either EA plus PCB or alfentanil plus PCB. Visual analogue scales (VAS) were used to evaluate subjective experiences during oocyte aspiration, and IVF outcome parameters were recorded. No differences in pain directly related to oocyte aspiration, adequacy of anaesthesia during oocyte aspiration, abdominal pain, or degree of nausea were found between the two groups in the VAS ratings. Before oocyte aspiration, the level of stress was significantly higher in the EA group than in the alfentanil group (P < 0.05), and the EA group experienced discomfort for a significantly longer period during oocyte aspiration (P < 0.01). Compared with the alfentanil group, the EA group had a significantly higher implantation rate (P < 0.05), pregnancy rate (P < 0.05), and take home baby rate (P < 0.05) per embryo transfer. In conclusion, EA has been shown to be as good an anaesthetic method as alfentanil during oocyte aspiration, and we suggest that EA may be a good alternative to conventional anaesthesia during oocyte aspiration.
Key words: alfentanil/anaesthesia/electro-acupuncture/implantation rate/oocyte aspiration, ivf
4 To whom correspondence should be addressed at: Department of Obstetrics and Gynaecology, Kvinnokliniken, Sahlgrenska University Hospital, SE-413 45 Göteborg, Sweden
Human Reproduction, Vol. 14, No. 10, 2480-2484, October 1999
© 1999 European Society of Human Reproduction and Embryology
May
21
IVF egg collection – acupuncture effective alternative to conventional pain relief
Posted by admin in IVF
Pain relief during oocyte retrieval with a new short duration electro-acupuncture technique–an alternative to conventional analgesic methods.
Humaidan P, Stener-Victorin E.
The Fertility Clinic, Skive Sygehus, DK 7800 Skive, Denmark.
BACKGROUND: Acupuncture previously has proved its pain-relieving effect for ovum pick-up (OPU). The analgesic effect of electro-acupuncture (EA) was evaluated when EA was applied for only a few minutes prior to OPU in an attempt to make EA more attractive for clinical use. METHODS: Two hundred patients undergoing OPU were randomized prospectively using sealed, unlabelled envelopes, to receive pain relief with either EA in combination with a paracervical block (PCB) (n = 100) or conventional medical analgesia (CMA) in combination with a PCB (n = 100). A visual analogue scale (VAS) was used to evaluate pain and anxiety before, during and after OPU. The primary outcome measure was pain relief; secondary end-points were costs, time to discharge and clinical outcome parameters. RESULTS: There were no differences in any VAS ratings before the procedure. Directly after OPU, the EA group reported significantly higher mean and maximum pain, and ‘pain now’ than the CMA group. At 30 min after OPU and thereafter, no significant differences were found between the groups regarding abdominal pain. Time to discharge and costs were significantly lower in the EA group compared with the CMA group. No differences in clinical outcome parameters were seen. CONCLUSION: A significant difference was found between the EA and the CMA groups regarding pain during the OPU, probably due to the fact that the CMA group was pre-medicated as part of the study design. Despite a per-operative difference in pain rating, EA, given a few minutes prior to OPU, is a good alternative to CMA. The procedure is well tolerated by the patients, with a shorter hospitalization time and lower costs.
Hum Reprod. 2004 Jun;19(6):1367-72. Epub 2004 Apr 22.
May
18
Acupuncture: Impact on Pregnancy Outcomes in IVF Patients
Posted by admin in acupuncture, ART, IVF
Acupuncture: Impact on Pregnancy Outcomes in IVF Patients
12th World Congress on Human Reproduction, Venice Italy March 2005
Paul C. Magarelli, M.D., Ph.D. Reproductive Medicine & Fertility Center, Colorado Springs www.475-baby.com
Diane Cridennda, L.Ac. East Winds Acupuncture www.eastwindsacupuncture.com
Mel Cohen, MBA Reproductive Medicine & Fertility Center, Colorado Springs
Abstract
Take Home babies’ rates (THB) have been the sine quo non of IVF outcomes. Pregnancy rates (PR) can overestimate the expected success of a high-technology treatment for patients and many clinics use PR as means of marketing their practices. This has caused disillusionment in patients and government regulation (especially in the U.S.). Each IVF program strives to improve reproductive outcomes (low ectopic rates, low miscarriage rates and improved take home baby rates – live births). Usually the approach to these improvements are changes in IVF protocols, media adjustments in the IVF lab, patient selection, and subtle nudges towards egg donors for poor responders. Another approach has been the inclusion of alternative medical modalities: acupuncture, massage therapy, stress reduction techniques, herbal medicine. We, and others, have chosen to incorporate Acupuncture into our IVF treatment protocols. Recently we presented two studies that demonstrated improvements in pregnancy rates in Good and Poor IVF Responders with the inclusion of two specific Acupuncture Protocols (Steiner-Victorin and Paulus et. Al). In the poor responders group we demonstrated a positive adjustment to Poor Responders pregnancy rates (PR) with improvements in PR in the Poor Responders group equivalent to good responders. In the Good Responders study we demonstrated a trend towards improved PR (5% above controls, not significant at p < 0.05). With these observations noted we have continued our investigation and are reporting on reproductive outcomes in all IVF patients treated with Acupuncture compared to those untreated.
Materials and Methods: In this study 130 IVF cycles were reviewed in a retrospective fashion. Patients demographics, years infertile, age of male partners, sperm parameters, Day 3 FSH, Pulsatility Indices, Weight, BMI, infertility diagnoses, IVF treatment protocols were statistically similar for both the Controls (C) and Acupuncture (Ac) treatment groups. All patients that completed an IVF cycle (retrieval, transfer) were included. There were 82 in the C group (non acupuncture) and 48 in the Ac group. For the C vs. Ac groups a summary of their statistics are as follows: Mean Age was 32.6 vs. 32.7, Day 3 FSH was 5.5 vs. 6.4, Pulsatility Indices for right and left uterine arteries were 1.5 and 1.2 vs. 1.4 and 1.0; Sperm counts were 69 vs. 67 million/ml; Sperm motility (%) were 48 vs. 53%, and Sperm morphologies were 6 % normal vs. 7%.
Results: Pregnancy rates for the Ac group were statistically similar, although numerically higher, versus C (50% v 45% at P < 0.05). Ac miscarriage rates (SAB) were statistically lower than the C (8 % vs. 11% at p <0.01). There were no ectopic pregnancies in the Ac group ( P < 0.01). Live Births were significantly better in the Ac v C groups (42% v 38%). A surprising observation was that multiples pregnancies were significantly lower in the Ac vs. C groups (17 % vs. 22%). Average eggs retrieved were statistically similar 15 vs. 15 for Ac and C respectively.
Conclusions: IVF programs can significantly improve their IVF outcomes ( PR, THB, SAB and Ectopic) by adding acupuncture protocols, specifically Steiner Victorin and Paulus. Further studies of Traditional Chine Medicine modalities of treatment are underway. We are organizing a multicenter prospective study to confirm our observations.
May
17
Acupuncture useful tool for improving pregnancy rate after ART(IVF, ICSI)
Posted by admin in acupuncture, ART, female infertility, ICSI, infertility, IVF
Fertil Steril. 2002 Apr;77(4):721-4.
Influence of acupuncture on the pregnancy rate in patients who undergo assisted reproduction therapy.
Paulus WE, Zhang M, Strehler E, El-Danasouri I, Sterzik K.
Department of Reproductive Medicine, Christian-Lauritzen-Institut, Ulm, Germany. paulus@reprotox.de
OBJECTIVE: To evaluate the effect of acupuncture on the pregnancy rate in assisted reproduction therapy (ART) by comparing a group of patients receiving acupuncture treatment shortly before and after embryo transfer with a control group receiving no acupuncture. DESIGN: Prospective randomized study. SETTING: Fertility center. PATIENT(S): After giving informed consent, 160 patients who were undergoing ART and who had good quality embryos were divided into the following two groups through random selection: embryo transfer with acupuncture (n = 80) and embryo transfer without acupuncture (n = 80). INTERVENTION(S): Acupuncture was performed in 80 patients 25 minutes before and after embryo transfer. In the control group, embryos were transferred without any supportive therapy. MAIN OUTCOME MEASURE(S): Clinical pregnancy was defined as the presence of a fetal sac during an ultrasound examination 6 weeks after embryo transfer.
RESULT(S): Clinical pregnancies were documented in 34 of 80 patients (42.5%) in the acupuncture group, whereas pregnancy rate was only 26.3% (21 out of 80 patients) in the control group.
CONCLUSION(S): Acupuncture seems to be a useful tool for improving pregnancy rate after ART.
May
11
Combination of western and Chinese medicine is the most effective method in treating tubal obstruction
Posted by admin in ART, Chinese herbs, female infertility, infertility, IVF
FALLOPIAN TUBE DYSFUNCTION AND CHINESE HERBAL MEIDCINE
A study was carried out in Guangzhou, China, to find an effective treatment for tubal obstruction. The results of 120 women divided into three treatment groups were compared. One group received a combination of Western medical treatment and Chinese herbal medicine, one group received Chinese herbal medicine only and another group received Western medical treatment only. After treatment, the fallopian tube patency rate 86.7% and the pregnancy rate 85.0% in the TCM/ WM group, 66.7% and 63.3% in the TCM group and 53.3% and 50% in the WM group respectively. The effectiveness in the combination group was significant. The authors conclude that the combination of western and Chinese medicine is the most effective method in treating tubal obstruction.
Kang JL, XIa W, He QY.’[Clinical study on treatment of oviduct obstruction by integrative traditional Chinese and Western medicine]. Zhongguo Zhong Xi Yi Jie He ZaZhi. 2001, 21 (6): 416-8.
May
11
Luteal-phase acupuncture improves outcomes of IVF/ICSI
Posted by admin in acupuncture, ART, female infertility, infertility, IVF, male infertility
Dieterle S, Ying G, Hatzmann W, Neuer A.
Fertil Steril. 2006 May;85(5):1347-51. Epub 2006 Apr 17.
Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Witten/Herdecke, Dortmund, Germany. Dieterle@IVF-Dortmund.de
OBJECTIVE: To determine the effect of luteal-phase acupuncture on the outcome of IVF/intracytoplasmic sperm injection (ICSI). DESIGN: Randomized, prospective, controlled clinical study.
SETTING: University IVF center.
PATIENT(S): Two hundred twenty-five infertile patients undergoing IVF/ICSI.
INTERVENTION(S): In group I, 116 patients received luteal-phase acupuncture according to the principles of traditional Chinese medicine. In group II, 109 patients received placebo acupuncture. MAIN OUTCOME MEASURE(S): Clinical and ongoing pregnancy rates.
RESULT(S): In group I, the clinical pregnancy rate and ongoing pregnancy rate (33.6% and 28.4%, respectively) were significantly higher than in group II (15.6% and 13.8%). CONCLUSION(S): Luteal-phase acupuncture has a positive effect on the outcome of IVF/ICSI.
May
11
Acupuncture on the day of IVF/ICSI embryo transfer significantly improves the outcome
Posted by admin in acupuncture, ART, female infertility, infertility, IVF
Acupuncture on the day of embryo transfer significantly improves the reproductive outcome in infertile women: a prospective, randomized trial
National Institute of Environmental Health Sciences
Vienna, Austria: There was heartening news today (Wednesday 3 July) for would-be parents worried because they had difficulty conceiving. A new study being presented to Europe’s leading reproductive medicine conference shows that most healthy couples concerned because the woman was not pregnant after a year of trying will conceive during the second year.
A US team from the National Institute of Environmental Health Sciences in North Carolina who analysed data on 782 couples from seven European cities1, concluded that even when the woman was aged between 35 and 39, fewer than 1 in 10 failed to conceive after 2 years unless the male partner was over 40.
Lead investigator Dr David Dunson suggested that couples should be patient and doctors should not intervene too fast with assisted reproductive techniques unless there are known reasons for a couple not conceiving naturally within a year.
He told the annual conference of the European Society of Human Reproduction and Embryology that recent research undertaken by his team showed that fertility in women started to decline as early as the late 20s and for men from their late 30s2 . But, this was due primarily to declines in the per menstrual cycle conception rate and not to an increase in the proportion of couples unable to achieve an unassisted pregnancy.
Now his team has extended their research using data from the European Fecundability Study to see what the implications are for fertility rates overall.
“On average the time to pregnancy increases with the age of the woman. The percentage failing to conceive within a year ranged from 8% for 19-26-year-olds to 13 to 14% for 27 to 34-year-olds to 18% for 35-39-year-olds.”
“But, regardless of age, most of the women who failed to conceive within the first 12 cycles conceived in the next 12. Only 3% of 19 to 26-year-olds, 6% of 27 to 34-year-olds and 9% of 35 to 39-year-olds failed to conceive in the second year, provided the male partner was aged under 40. Starting in the late 30s though, male age was also important: it meant that the percentage of failures after one year for women aged 35 to 39 rose from 18% to 28% if the male partner was over 40. After the second year the figure was 9% with male partners under 40 and 16% with male partners over 40.”
Dr Dunson said there were clear increases with age in the number of menstrual cycles needed to achieve pregnancy and in the probability of being classified as clinically infertile – a definition applied after a year of trying to conceive.
But, their research had clearly shown that among outwardly healthy couples with no known conditions associated with infertility, most who failed to conceive naturally within the first year will conceive naturally in the second year – regardless of age.
“So, in the absence of clinical indicators of infertility in addition to a long time to pregnancy, it may be appropriate to delay assisted reproduction until the couple has failed to conceive naturally in 18 to 24 months. There is a large amount of normal variability in fertility and many couples having below average, but normal fertility may fail to conceive within a year. This is particularly true for older couples, many of whom fail to conceive within the first year but are successful in the second.”
He said it was important for doctors to avoid recommending assisted reproduction too soon due to well-documented side effects. “Fertility treatment, such as IVF and ICSI, can result in an increased risk of multiple pregnancies, pregnancy complications, low birth weight, major birth defects and long-term disability among surviving infants. In addition, the chance of success with ART decreases with age, while the side effects increase in prevalence.”
1 Data were drawn from a large multinational study – the European Study of Daily Fecundability. It enrolled 782 women aged between 18 and 40 from seven centres – Milan, Verona, Lugano, Dusseldorf, Paris, London and Brussels. The participants kept daily records of basal body temperature and recorded the days on which intercourse and menstrual bleeding occurred. Data on 7,288 menstrual cycles contributed to the study.
2 Changes with age in the level and duration of fertility in the menstrual cycle. Human Reproduction. D. Dunson et al. Vol. 17. No 5. pp 1399-1403
May
10
Acupuncture prior to and at IVF embryo transfer
Posted by admin in acupuncture, ART, female infertility, infertility, IVF
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.
Mar
11
Acupuncture and ART
Posted by admin in acupuncture, ART, female infertility, infertility, IVF, male infertility
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.
Feb
26
Acupuncture and IVF embryo transfer, ART and PCOS
Posted by admin in acupuncture, ART, IVF, polycystic ovaries
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.
Feb
18
Improvement of IVF Outcomes by Acupuncture: Are egg and embryo qualities involved?
Posted by admin in acupuncture, ART, IVF
Improvement of IVF Outcomes by Acupuncture: Are egg and embryo qualities involved?
Paul C. Magarelli, M.D., Ph.D., a Diane Cridennda, L.Ac. b, Mel Cohen, MBA a
a Reproductive Medicine & Fertility Center, Colorado Springs, CO b East Winds Acupuncture, Colorado Springs, CO
FERTILITY AND STERILITY®, May 2005, VOL 83, SUP 2, Proceeding from the 2005 Pacific Coast Reproductive Society annual meeting in Palm Springs
Objective: In this study, we examine the impact of Acupuncture on the embryology characteristics of IVF patients, i.e., are there changes in the numbers of eggs generated, embryos fertilized, embryos transferred or remaining embryos for freezing in those patients receiving acupuncture therapy.
Design: Retrospective clinical study
Setting: Private infertility practice and Traditional Chinese Medicine practice
Patients: Two hundred eight IVF cycles were reviewed, 95 received acupuncture (Ac) and 113 were controls (C).
Interventions: Patients randomly chose Ac to complement their IVF treatments. Two published Ac protocols were used. Standard IVF protocols were used and done in one clinic by one physician. The MD was not aware of who received Ac in addition to their IVF. After three years the data were collected and analyzed.
Main Outcome Measures: Number of eggs retrieved, number of eggs fertilized normally, number of embryos implanted, number of embryos frozen, number of embryos transferred, day of transfer, number of prior IVF cycles, Day 3 FSH, Pulsatility Indices, weight, infertility diagnoses, IVF treatment protocols, pregnancy rates, SAB rates, ectopic rates, and multiple pregnancy rates.
Results: Number of prior IVF cycles, Day 3 FSH, Pulsatility Indices, Weight, Infertility diagnoses, IVF treatment protocols were statistically similar. Pregnancy rates for the Ac group were statistically significantly higher than the C group (P ≤ 0.05), SAB rates were lower and multiple pregnancy rates were lower (P < 0.06, not statistically significant). Ectopic pregnancy rates were statistically lower in the Ac group (P ≤ 0.05). There were no statistically significant differences between the C and Ac treated groups for the following embryology parameters: number of eggs retrieved, number of eggs fertilized normally, number of embryos implanted, number of embryos frozen, number of embryos transferred, and day of transfer.
Conclusions: There were no discernable statistical differences between embryology characteristics in patients treated with or without Acupuncture. These data suggests that the mechanism of action of Acupuncture on IVF outcomes may be related to affects in the host (the egg provider and the embryo recipient) rather than in direct changes to the eggs retrieved and the embryos created.
Key Words: IVF, acupuncture, adjuvant therapies, electro stimulation acupuncture, embryology, eggs