Integrating Acupuncture into IVF Treatments: A New Hope for Overcoming Recurrent Implantation Failure

Recent research published in the Journal of Assisted Reproduction and Genetics has revealed a significant breakthrough in the treatment of recurrent implantation failure (RIF) in IVF embryo transfer procedures. This comprehensive study explores the effectiveness of combining acupuncture with gonadotropin-releasing hormone agonists (GnRHa) for improving endometrial receptivity and overall pregnancy outcomes.

The Challenge of Recurrent Implantation Failure (RIF)

For many couples undergoing in vitro fertilization (IVF), RIF is a major hurdle. It is defined as the absence of clinical pregnancy despite the transfer of multiple high-quality embryos. The emotional and physical toll of repeated failures can be overwhelming, prompting many to seek alternative therapies that could tip the scales in their favor.

Study Insights: Acupuncture made a significant difference

The investigation focused on 164 patients experiencing recurrent implantation failure (RIF) during their IVF-embryo transfer processes. The participants were systematically categorized into two groups: a control group, which continued with the standard hormone replacement therapy (HRT) for endometrial preparation, and a study group, which received an innovative combination of acupuncture, gonadotropin-releasing hormone agonists (GnRHa), and HRT. The findings from this comparative analysis revealed notable enhancements in the study group:

• Endometrial Thickness: The study group, treated with acupuncture in conjunction with GnRHa, showed a significant increase in endometrial thickness compared to the control group. This factor is crucial as a thicker endometrium is often associated with higher rates of embryo implantation.
• Morphological Improvements: There was a higher prevalence of favorable endometrial morphologies, specifically linear endometrium (A + B type), in the study group. Such morphological features are considered beneficial for embryo implantation, indicating a receptive uterine environment.
• Blood Flow Enhancement: The study group also demonstrated enhanced submucosal uterine blood flow, particularly with an increase in type III flow patterns. Improved blood flow to the uterus is essential for creating a nourishing environment that supports embryo implantation and growth.

These results underscore the potential benefits of integrating acupuncture with GnRHa in the treatment protocol for patients undergoing IVF, especially those with a history of RIF, by improving endometrial receptivity and overall pregnancy outcomes.

 

As you can see the embryo implantation rate was much higher when acupuncture was used. Consequently this also resulted in much higher pregnancy rate. How can the pregnancy be higher than implantation rate? This difference due to more than one embryo being transferred in both control group (approximately 1.82 per cycle) and acupuncture group (1.76 per cycle). Effectively, there were fewer embryos transferred in the control group, but it still resulted in much higher pregnancy rate.

 

 

Why  is recurrent implantation failure such a challenging diagnosis?

Emotional Impact: RIF can be emotionally and psychologically draining for patients. For instance, the repeated failure despite having high-quality embryos transferred can lead to significant stress, anxiety, and depression, which can, in turn, impact overall health and potentially interfere with treatment outcomes.

• Complex Etiology: RIF maybe influenced by a multitude of factors including embryo quality, genetic issues, anatomical problems of the uterus, immunological factors, and the endometrial environment. Each of these factors can vary significantly from patient to patient, making it difficult to pinpoint the exact cause of implantation failure in each case.
• Treatment Challenges: Because RIF can be caused by many different factors, there isn’t a one-size-fits-all treatment. Health professionals must often use a trial-and-error approach to find the most effective treatment for an individual, which can be time-consuming and frustrating for both the patient and the clinician.
• Financial Strain: IVF cycles and additional interventions to address RIF can quickly add up.  Many IVF cycles may be needed before a successful pregnancy is achieved. This financial burden can be significant, especially as most insurance plans do not cover the full costs of multiple IVF attempts.
• Impact on Future Fertility Decisions: The challenges and uncertainties associated with RIF can influence future fertility decisions. Couples may reconsider their options, weighing the emotional and financial impacts against the desire to continue trying for a biological child.

Addressing the Complex Etiology of RIF: Further thoughts why acupuncture may be helpful with Recurrent Implantation Failure

RIF’s complexity stems from various factors, including embryo quality, genetic issues, anatomical and immunological factors, and the endometrial environment. Acupuncture has been shown to benefit numerous and diverse diagnoses such as endometriosis, PCOS, back pain, hayfever and migraines to name a few. It offers a multifaceted therapeutic approach that addresses several underlying causes:

• Endometrial Receptivity: Enhances blood flow and thickness of the endometrium.
• Immunological Factors: Modulates immune responses, potentially reducing inflammation.
• Hormonal Regulation: Influences hormonal balance crucial for fertility.
  Stress Reduction: Lowers stress levels, which can negatively impact fertility.
• Stress Reduction: Lowers stress levels, which can impact fertility.

This study highlights the benefits of integrating acupuncture with IVF in managing RIF, offering a more effective and holistic approach to overcoming this fertility challenge. For many couples, this could mean a renewed hope and a higher chance of achieving the dream of parenthood.

Study abstract:

J Assist Reprod Genet
. 2024 Jun 7. doi: 10.1007/s10815-024-03140-7. Online ahead of print.

Acupuncture combined with gonadotropin-releasing hormone agonists improves endometrial receptivity and pregnancy outcome in patients with recurrent implantation failure of in vitro fertilization-embryo transfer

Jingya Yang # 1, Yan Lu # 2, Yuan Zhang 1, Cuijuan Zhou 1, Qin Liang 1, Ting Liang 3
Affiliations expand
PMID: 38847932 DOI: 10.1007/s10815-024-03140-7
Abstract
Objective: Gonadotropin-releasing hormone agonists (GnRHa), combined with other auxiliary treatments, can improve pregnancy outcomes in in vitro fertilization-embryo transfer (IVF-ET). This research investigated the effect of acupuncture combined with GnRHa in patients with recurrent implantation failure (RIF) of IVF-ET.

Methods: A total of 164 patients who intended to undergo frozen-thawed embryo transfer after RIF of IVF-ET were selected for experiments and then divided into the control (received conventional hormone replacement therapy (HRT) for endometrial preparation) and study groups (received a combination of acupuncture, GnRHa, and HRT for endometrial preparation) (n = 82). Endometrial thickness (EMT), endometrial morphological classification, submucosal uterine blood flow classification, clinical pregnancy rate, embryo implantation rate, and early abortion rate for each transfer cycle were compared between the two groups.

Results: EMT of the study group was higher than that of the control group 1 day before transfer. There were more patients with linear endometrium (A + B type) in the study group on the day of endometrial transformation than in the control group. The number of patients with type I submucosal uterine blood flow in the study group was decreased and the number of patients with type III was increased compared with the control group on the day of endometrial transformation. The clinical pregnancy rate and embryo implantation rate of the study group were higher than those of the control group.

Conclusion: Acupuncture combined with GnRHa improves the endometrial receptivity of patients with RIF of IVF-ET, thereby increasing clinical pregnancy rates and improving pregnancy outcomes.

Keywords: In vitro fertilization-embryo transfer; Acupuncture; Endometrial receptivity; Gonadotropin-releasing hormone agonists; Pregnancy outcome; Recurrent implantation failure.

© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

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