Can IVF acupuncture improve live birth rates, aka take home babies?

Despite 20 years of vigorous IVF research, we still are trying to find an answer. When you browse our blog you will read many IVF studies where acupuncture group had higher numbers of pregnancies or live births. But there are a few studies that show no effect on pregnancy rates. However, they often have other benefits, like improved embryo quality or better blood flow in the uterus or reduced stress. All in all, IVF acupuncture research may seem a bit hard to draw clear conclusions.

If you think that evidence is a bit confusing, here is a perfect study to clear things up.

Our ABORM colleague Lee Hullender Rubin in December 2019 published an article diving deep into current IVF acupuncture situation. She took two latest and most rigorous systematic reviews and meta-analysis; picked them apart and came up with a pretty neat overview.

Here you have it, a summary on what acupuncture can do during your next IVF, according to data of 1980 women.

The summary of the current evidence on how acupuncture influences IVF outcomes

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Are you labelled as a poor IVF responder? Is there a way you can up your chances of making a baby? You know there are not many options. Can acupuncture help?

IVF is the numbers game. The important part of IVF is for your ovaries to safely produce as many follicles as possible. And poor IVF responders’ ovaries, as the name suggests, don’t grow many follicles. This means these IVF cycles are often cancelled. If you are lucky you may end up with a couple of oocytes. Furthermore, those eggs are less likely to turn into embryos.

The poor ovarian response (POR) is a diagnosis no one wants when trying to conceive. IVF clinics can’t do much to help you respond better. There are several IVF protocols you can try, but unfortunately, they are seldom successful.

So, what does poor IVF response diagnosis mean? Let’s take it apart.

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Can fertility acupuncture help depression? Sounds like it has nothing to do with each other. But let’s have a closer look.

Relax and it will happen, they say. Does your stress cause infertility or does the emotional rollercoaster of not being able to conceive lead to stress and depression? Stress and infertility – a classic Catch-22?

Couples with infertility have increased levels of anxiety and depression. This is a fact. Infertility causes significant distress.

Unmanaged depression can have a negative effect on a couple’s relationship.  It affects libido in both partners, it even has a toll on sperm quality.  Furthermore, men who have major depression are less likely to conceive a child. And women with severe symptoms have 38 per cent fewer conceptions each month.

So what should you do? Are there any safe treatment options?

Many studies have explored and showed the negative effects of antidepressants on pregnancy and on a baby. We are not yet certain how these drugs affect fertility.

For instance, women undergoing medical treatment for depression are more likely to miscarry. The same study links the use of antidepressants and male infertility.  If you are in a position to choose, discuss non-pharmaceutical treatment with your doctor.

How to overcome your depression naturally when trying for a baby

There are a few effective non-drug interventions. We recommend a combination of

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Prepare the soil before planting the seed, the saying goes. The endometrial lining is where the future baby (embryo) attaches to, where it gets nutrition and grows. The healthy lining is important to reduce the risk of early miscarriage.

So, what is the fertile soil for the baby? The ideal endometrial lining before the implantation is about 8mm in thickness. It has good circulation, and ideally, it has a three-layer pattern (it can be seen on the ultrasound).

Women undergoing IVF with better blood circulation in the endometrium have more live births.

Developing embryo gets nutrients from endometrial lining until at least the tenth week of pregnancy. It regulates placental growth and differentiation.

Treatments that optimise your endometrium’s receptivity are limited. We also don’t know of lifestyle interventions which are proven to help.

Why you should try acupuncture

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In this post, we’ll discuss the article published in JAMA “The Effects of Acupuncture vs Sham Acupuncture on Live Birth Rates Among Women Undergoing In Vitro Fertilization” (1).

I know, these comments may include technical jargon, which may be hard to understand for a lay person. This post is mostly for healthcare providers helping them understand this particular study.

This new study questions acupuncture’s effects on IVF pregnancy outcomes, but when you peruse the paper carefully the validity of it comes into the red zone for several reasons: Read more

Our patients often ask how acupuncture boosts fertility.

One of the ways is by reducing inflammation in the reproductive system.

I recently came across this little study showing acupuncture’s anti-inflammatory effects for pelvic inflammatory disease.

Pelvic inflammatory disease (PID) is acute inflammation in your reproductive organs.  It is a complication often caused by STIs, like chlamydia or gonorrhea. With a recent rise in reported STIs cases in New Zealand, there is an increased risk of women developing the pelvic inflammatory disease.

It’s concerning as you may not realise you have PID.  Symptoms may be mild, or you may not feel any difference at all.  However, if you have symptoms like

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How many acupuncture treatments do you need to improve IVF outcomes?

Our own analysis of IVF acupuncture studies has shown that the treatment protocol for IVF patients needs to take into account your specific situation.

Furthermore, the results can be significantly improved when we use the comprehensive approach of TCM diagnosis and make use of both acupuncture and herbal medicines 3+ months leading to IVF. And our colleagues who did their research agree. Furthermore, below is a study published this month suggesting that three acupuncture sessions around the day of embryo transfer are insufficient intervention.

There are situations where you will not have enough notice, or you will learn about acupuncture late in the IVF process. It may be not too late. You can still benefit from a shorter course of treatment. As an example, studies have shown that when done correctly, even four acupuncture sessions can improve uterine blood flow. If you’re willing to benefit from this treatment, please get in touch with us as early as possible. If you started IVF and you feel like it’s too late don’t worry. There are still ways how we may help improve your chances of success. When we apply the correct approach, we can make a difference even after you’ve started IVF.

If your fertility is on the rapid decline because of your age, or other factors, delaying IVF to boost your fertility may not be wise. We take every aspect of your reproductive and general health into consideration. During your initial appointment, we discuss all options with you so you can choose.

We’ve prepared a lecture on the strategies of designing optimal individualised acupuncture protocol. This lecture soon will be available via a leading continuing medical education provider shortly.

Get in touch if you’re interested to learn about the optimal protocol for IVF Acupuncture.

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Unexplained infertility probably is the most heartbreaking diagnosis. Not knowing why you can’t get pregnant is frustrating.

The principal treatments for unexplained infertility are recommendations for timed intercourse, lifestyle changes, Clomiphene citrate, intrauterine insemination (IUI) or in vitro fertilization (IVF). Recently, Lipoidal flushing showed promising results.

What role does acupuncture play in treating unexplained infertility?

We see reproductive acupuncture benefits and results for couples with unexplained infertility in our clinical practice. We have seen patients who were under specialist care and tried everything else for as long as 7 years conceiving naturally under our care. However, acupuncture research is technically challenging and underfunded, there are only a few research papers that analyse this issue.

So understandably, I was excited to see a paper that took a challenge and looked into acupuncture’s benefits for unexplained infertility. It is unfortunate they did not utilise the power of acupuncture fully by using everything available. Nonetheless, the women who had acupuncture were better off.

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Stress affects your fertility. We can’t ignore this fact any longer.

Furthermore, long-term stress can reduce your IVF success. UK scientists measured cortisol levels in women undergoing IVF. They took samples of hair and saliva. Hair sampling allows analysis of cortisol over the preceding 3–6 months. While saliva sample shows immediate stress levels. Results were eye-opening. Women exposed to chronic stress were 27% less likely to conceive with IVF.

How many acupuncture sessions do you need to have a significant impact on stress?

Is it realistic to think that a single acupuncture session can reduce the cumulative effects of stress that has happened over a longer period, say 3-6 months?

A recent study led by Dr Sutton explored this question. They compared a month of regular acupuncture with one session on the day of embryo transfer. Acupuncture on the day of embryo transfer is often recommended by reproductive endocrinologists.

To no surprise women who had several acupuncture sessions felt more relaxed. Unfortunately, researchers didn’t further explore if acupuncture dose has an impact on pregnancy rates.

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When you decide to have a family, you want to get pregnant fast. How can you speed up your fertility journey? Does it feel like you have tried everything? But have you?

Recently I found a fertility acupuncture study from Australia, which has some good tips.

What we know about fertility acupuncture mostly comes from the studies about IVF. In contrast to IVF research, general reproductive acupuncture studies are hard to come by. While we see many IVF patients, about 50% of our couples are trying to conceive naturally, in the privacy of their homes. So studies discussing Chinese Medicine treatment for fertility without IVF are interesting to us and our switched-on patients.

Can you actually get pregnant faster without IVF?

This Australian study explored the effect of acupuncture on fertility awareness and regularity of your cycle. But what they actually discovered will surprise you.

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In this study, researchers investigated how acupuncture influenced ovarian reserve in women who had low ovarian reserve or “very few eggs left”. They used a kind of acupuncture with no needles, where very gentle electric impulses are used to stimulate acupuncture points. This study has shown improved the hormone levels including Anti-Müllerian Hormone (AMH). AMH test is a test often used by IVF clinics to estimate response to the IVF drugs. Researchers observed increased number of eggs collected with IVF. The embryo quality was also improved. Consequently, women who had acupuncture had better IVF pregnancy outcomes.

The study was published in The Journal of Obstetrics and Gynaecology Research.

Are you interested in learning how your fertility can be optimised with acupuncture?  Contact Dr Vitalis Acupuncture Auckland.

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How does reproductive acupuncture compares to the medication at improving ovulation?

One of the causes of anovulation is luteinised unruptured follicle syndrome (LUFS).

LUFS affects 5%-10% of healthy women and 25%-43% of women with infertility. This syndrome is more common among women diagnosed with endometriosis.

Most commonly LUFS is diagnosed during a series of ultrasound scans.

In women with LUFS, the dominant follicle will grow bigger than usual (up to 4 centimeters). The follicle will undergo the luteinisation process, but it will not rupture during the midcycle to release the mature egg. Progesterone levels will increase as if you have ovulated. Your endometrium will undergo premenstrual changes. In other words, you won’t be able to see any difference in your period. The menstrual flow will be no different from a healthy menstrual cycle. But, obviously, if the egg is not released, and if you have LUFS it is not, pregnancy cannot happen.

There is a clear explanation of why some women get LUFS.  The main treatment for it is ovulation induction with hCG hormonal injection or Clomiphene. These treatments are a risk of hyperstimulation syndrome and other side-effects.

Does acupuncture offer a treatment alternative to anovulation?

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

hyperprolactinemia-prolactinoma

 

Hyperprolactinemia 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 a 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 a 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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Impact of whole systems traditional Chinese medicine on in-vitro fertilization outcomes.

Hullender Rubin LE, Opsahl MS, Wiemer KE, Mist SD, Caughey AB.

Abstract

Patients undergoing IVF may receive either acupuncture or whole-systems traditional Chinese medicine (WS-TCM) as an adjuvant IVF treatment.

WS-TCM is a complex intervention that can include acupuncture, Chinese herbal medicine, dietary, lifestyle recommendations.

n this retrospective cohort study, 1231 IVF patient records were reviewed to assess the effect of adjuvant WS-TCM on IVF outcomes compared among three groups: IVF with no additional treatment; IVF and elective acupuncture on the day of embryo transfer; or IVF and elective WS-TCM. The primary outcome was live birth.

Of 1069 non-donor cycles, WS-TCM was associated with greater odds of live birth compared with IVF alone (adjusted odds ratio [AOR] 2.09; 95% confidence interval [CI] 1.36 to 3.21), or embryo transfer with acupuncture only (AOR 1.62; 95% CI 1.04 to 2.52).

Of 162 donor cycles, WS-TCM was associated with increased live births compared with all groups (odds ratio [OR] 3.72; 95% CI 1.05 to 13.24, unadjusted) or embryo transfer with acupuncture only (OR 4.09; 95% CI: 1.02 to 16.38, unadjusted).

Overall, IVF with adjuvant WS-TCM was associated with greater odds of live birth in donor and non-donor cycles. These results should be taken cautiously as more rigorous research is needed.

 

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 the 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 a preventative measure to reduce the risks for the developing baby.

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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

PCOS 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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ohss This 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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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 sperm acupuncture Impact of stress on female infertility and pregnancy has been well documented. Below study, published in the journal of Fertility and Sterility, 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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