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.
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.
This recent study highlights how acupuncture, specifically electro-acupuncture (EA), can reduce the risk of ovarian hyperstimulation in IVF patients. Despite some limitations, the findings are crucial for tailoring acupuncture protocols to each IVF patient’s needs.
Published in the Chinese Journal of Integrated Traditional and Western Medicine, the research by Hong YL and colleagues from the Department of Gynecology at Nanjing University of Chinese Medicine examined the effects of EA on clinical outcomes and the occurrence of ovarian hyperstimulation syndrome (OHSS) in in vitro fertilization and embryo transplantation.
The study involved 109 patients at a Reproductive Center, divided into a control group and an EA group based on their appointment dates. While the control group underwent standard ovarian stimulation protocols, the EA group received additional electro-acupuncture from the start of their Gn injection until the day of embryo transfer.
Key findings from the study include:
Significantly lower estradiol levels on the day of ovum pick up (OPU) and embryo transfer (ET) in the EA group.
Decreased levels of vascular endothelial growth factor (VEGF) and interleukin-6 (IL-6), which are linked to the severity of OHSS, on key treatment days.
A notable reduction in the occurrence of OHSS and the cancellation rate of the transplant cycle in the EA group.
These results suggest that electro-acupuncture could be a valuable adjunct therapy in IVF treatments, potentially reducing the risk of OHSS. This study underscores the importance of integrating traditional techniques like acupuncture with modern reproductive technologies, offering a holistic approach to fertility treatments.
[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.
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.
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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 increase the uterine blood flow (decreasing uterine blood impedance). But does this boost to blood flow really matter when you’re having an IVF? This study below provides the answer. The researchers utilised specialised ultrasound method to assess uterine blood flow. They discovered that it had an immense effect on both pregnancy and implantation rates. IVF with women, who had the lowest blood flow below a certain level on the day of transfer, unfortunately didn’t result in any pregnancies.
In this study the blood flow is referred to as uterine blood flow impedance and pulsatility index(PI). The higher the impedance and PI, the lower the blood flow. None of the women who had PI value above 3 conceived.
Yet another study shows that acupuncture does quite a bit more in the abdominal cavity than just increasing the blood flow to ovaries and uterus. Obviously, the study doesn’t directly link with treatment of infertility, but the promise is there.
Zhen Ci Yan Jiu. 2014 Apr;39(2):156-63. [A meta-analysis on effectiveness of acupuncture and moxibustion for chronic pelvic inflammatory disease]. Fan LL, Yu WH, Liu XQ, Cui Z, Ma J, Li CP.
Abstract
OBJECTIVE:
To evaluate the clinical effect of acupuncture and moxibustion therapies for chronic pelvic inflammatory disease (CPID) by Meta-analysis. Read more
Successful implantation is an absolute prerequisite for a successful pregnancy. The process by which a blastocyst is accepted by endometrium is involved and requires an interplay of many systems.
The researchers of this study have discovered acupuncture can optimise this subtle uterine environment by modulating cytokines, and therefore it can increase the implantation rate.
This study by Beijing Hospital of Obstetrics and Gynecology has shown acupuncture to be superior to clomophene on ovulation and pregnancy rates in treatment of polycystic ovary syndrome.
Other studies have shown that unlike Clomophene, acupuncture can have long term effect on PCOS by reducing the sympathetic nervous tonus. Apart from study methodology issues, another limitation of this study is that it only looked into the short term effect, but didn’t evaluate the effectiveness over a longer term. However, this is another study adding to the body of evidence. The study was published in the journal of Zhongguo Zhen jiu (Chinese Journal of Acupuncture & Moxibustion [2013, 33(11):961-964]).
Efficacy and safety evaluation of acupuncture combined with auricular acupoint therapy in the treatment of polycystic ovary syndrome
Department of Acupuncture and Physical Therapy, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China. geyongchun1981@sina.com
Zhongguo Zhen jiu = Chinese Acupuncture & Moxibustion [2013, 33(11):961-964]
Type: Journal Article, English Abstract (lang: chi)
OBJECTIVE: To compare the efficacy differences between acupuncture combined with auricular acupoint therapy and clomiphene oral administration in the treatment of polycystic ovary syndrome (PCOS).
METHODS: One hundred cases of PCOS were randomized into two groups, 50 cases in each one. Acupuncture combined with auricular acupuncture group (group A): acupuncture was applied at Guanyuan (CV 4), Zhongji (CV 3) and Zigong (EX-CA 1), once daily; auricular point sticking was applied at Spleen (pi, CO13), Endocrine (neifenmi, CO18), Uterus and Kidney (shen, CO10), the plaster was changed once a week. Clomiphene group (group B): oral clomiphene was prescribed at the 5th day of the menstrual, for 5 consecutive days, totally 3 menstrual cycles was needed. The ovulation induction, pregnancy and menstruation resuming of patients in the two ‘ , The totally effective rate was 90.00% (45/50) in group A, which was group were observed and compared.
RESULTS: The totally effective rate was 90.0% (45/50) in group A, which was superior to 86.0% (43/50) in group B (P<0.05); the ovulation rate and pregnancy rate were 68.0% (34/50)and 64. 0% (32/50) in group A, which were superior to that of group B (all P<0. 05); the menstruation resuming rate was 94.00 (47/50) in group A, which was superior to 88.00 (44/50) in group B (P<0.05). No adverse effect was observed in group A, while in group B, varying degrees of nausea, vomiting, headache and dermatitis were observed in 29 cases, ovarian hyperstimulation syndrome (OHSS) like polycystic ovary was observed in 14 cases under the B ultrasound.
CONCLUSION: Acupuncture combined with auricular acupoint therapy has a better effect than clomiphene in the treatment of PCOS without any adverse effects.
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A truly thorough, well-referenced paper exploring the mechanism and effects of acupuncture on PCOS. Written by leading PCOS researchers from the Karolinska Institute in Sweden.
Polycystic Ovary Syndrome: Effect and Mechanisms of Acupuncture for Ovulation Induction
Julia Johansson and Elisabet Stener-Victorin
Abstract
Polycystic ovary syndrome (PCOS), the most common endocrine disorder among women of reproductive age, is characterized by the coexistence of hyperandrogenism, ovulatory dysfunction, and polycystic ovaries (PCO). PCOS also represents the largest part of female oligoovulatory infertility, and the management of ovulatory and menstrual dysfunction comprises a third of the high costs of PCOS treatment. Current pharmacological and surgical treatments for reproductive symptoms are effective, however, associated with negative side effects, such as cardiovascular complications and multiple pregnancies. For menstrual irregularities and ovulation induction in women with PCOS, acupuncture has indicated beneficial effects. This review will focus on the results from randomized controlled acupuncture trials for the regulation of menstrual dysfunction and for inducing ovulation in women with PCOS although there are uncontrolled trials with nonetheless interesting results. Animal experimental studies will be further discussed when they can provide a more mechanistic explanatory view. Read more
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The short answer is yes, acupuncture can improve embryo quality. Now let’s have a look into study details.
Dr Rashidi and his team explored if acupuncture can improve pregnancy rates for PCOS patients undergoing IVF and ICSI. As a result, they found that acupuncture can improve embryo quality.
Acupuncture showed considerable advantages over the metformin for obese PCOS patients. Acupuncture was shown to be more effective then metformin at improving menstrual freqency, reducing body mass index and waist to hip ratio. It also had fewer side-effects.
Effectiveness of Abdominal Acupuncture for Patients with Obesity-Type Polycystic Ovary Syndrome: A Randomized Controlled Trial
To cite this article:
Yan-Hua Zheng, Xin-Hua Wang, Mao-Hua Lai, Hong Yao, Hua Liu, and Hong-Xia Ma. The Journal of Alternative and Complementary Medicine. -Not available-, ahead of print. doi:10.1089/acm.2012.0429.
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This study shows that there is a significant benefit to integrate acupuncture with IVF treatment for patients with two or more failed IVF cycles. It is one of the few studies using sham acupuncture to ensure that the effect of acupuncture is real, not just a placebo. The study was published in a reputable, pier-reviewed journal Acupuncture in Medicine, BMJ journals.
Influence of acupuncture on the outcomes of in vitro fertilisation when embryo implantation has failed: a prospective randomised controlled clinical trial.
Isoyama Manca di Villahermosa D, Dos Santos LG, Nogueira MB, Vilarino FL, Barbosa CP.
Source
Faculty of Medicine of ABC, Clinic for Human Reproduction, , Santo André, São Paulo, Brazil.
Abstract
OBJECTIVE:
To evaluate the effectiveness of acupuncture and moxibustion as an adjuvant treatment in women undergoing in vitro fertilisation (IVF) when embryo implantation has failed.
METHODS:
A prospective, randomised controlled clinical trial was conducted with 84 infertile patients who had had at least two unsuccessful attempts of IVF. The patients were randomised in three groups: control (n=28), sham (n=28) and acupuncture (n=28). The sample size was calculated by assuming a pregnancy rate of 10% when embryo implantation had failed. The pregnancy rates of the current IVF cycle were evaluated by measurement of blood beta human chorionic gonadotrophin (beta hCG) and subsequent transvaginal ultrasound. Acupuncture was performed on the first and seventh day of ovulation induction, on the day before ovarian puncture and on the day after embryo transfer. In the acupuncture group, patients were treated with moxibustion at nine acupuncture points (BL18, BL22, BL23, BL52, CV3, CV4, CV5, CV7, GV4) and needling at 12 points. In the sham group needles were inserted in eight areas that did not correspond to known acupuncture points.
RESULTS:
The clinical pregnancy rate in the acupuncture group was significantly higher than that in the control and sham groups (35.7% vs 7.1% vs 10.7%; p=0.0169).
CONCLUSIONS:
In this study, acupuncture and moxibustion increased pregnancy rates when used as an adjuvant treatment in women undergoing IVF, when embryo implantation had failed.
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This study demonstrates that acupuncture has a synergystic effect with Chinese Herbal medicine in treatment of Endometriosis. Furthermore the effect of acupuncture and herbal medicine was found to be superior to a pharmaceutical medicine Danazol. The abstract of the study is below.
Acupuncture enhances the effects of Chinese herbal Medicine in treatment of Endometriosis
J. Shi, Z. B. Z. Ge*
, Y. Jin,Y. D. Li and J. Zhou** The 1st Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, Zhejiang, China
*Sir Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, 310016, Zhejiang, China
**College of Food Science and Biotechnology, Zhejiang Gongshang University, Hangzhou, Zhejiang, 310012, China. Corresponding Author Email: juezhou2006@yahoo.com.cn
ABSTRACT
The present study was aimed to investigate whether acupuncture could significantly enhance the efficacy of Chinese herbal medicine (CHM) in treating endometriosis model rats. A total of 40 female Sprague-Dawley (SD) rats with body weight of 200 ±20 g were included. Operational transplantation was used with animal models. The rats were randomly divided into 5 groups: sham-operation control group (Group A), model group (Group B), CHM combined with acupuncture group (Group C), CHM group (Group D), Danazol group (Group E) with 8 rats in each group. During the treatment, two rats in Group B and one rat in Group E passed away. When the treatment ended, all the left rats were sacrificed. The samples of peritoneal fluids, serum and the ectopic endometrium were taken. The serum levels of cancer antigen 125 (CA-125) and interleukin 18(IL-18) in the peritoneal fluids were detected using enzyme-linked immune-sorbent assay. The cyclooxygenase-2 (COX-2) mRNA expression levels in the ectopic endometrium were measured by Real-time PCR. The results showed that in the rats from Groups A, C, D and E, the serum CA-125 levels, COX-2 mRNA expression in the ectopic endometrium and the IL-18 levels in the peritoneal fluids were significantly lower than those of Group B (P<0.05). The serum CA-125 levels and COX-2 mRNA expression in the ectopic endometrium of the rats in Group C were significantly lower than those of Group D (P<0.05), while there was no significant difference between Group C and E (P>0.05). The levels of IL-18 in the peritoneal fluids of the rats in Group C were markedly lower than those of Group D and E (P<0.05). It is then concluded that acupuncture treatment can improve the effects of CHM in treating endometriosis model rats. Key words: Chinese herbal medicine acupuncture; endometriosis
Reference: The Journal of Animal & Plant Sciences, 23(1): 2013, Page: 298-303 ISSN: 1018-7081
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This systematic review on Acupuncture and IVF is especially interesting. The studies of the well researched German protocol show acupuncture to be effective on the day of embryo replacement. This systematic review shows that acupuncture during ovarian stimulation also plays significant role in increasing the pregnancy outcomes of IVF.
The role of acupuncture in assisted reproductive technology.
Zheng CH, Zhang MM, Huang GY, Wang W.
Abstract
The aim of this paper was to provide reliable evidence by performing a systematic review and meta-analysis for evaluating the role of acupuncture in assisted reproductive technology. All randomized controlled trials that evaluated the effects of acupuncture, including manual, electrical, and laser acupuncture (LA) techniques, on the clinical pregnancy rate (CPR) and live birth rate (LBR) of in vitro fertilization (IVF) or artificial insemination were included. The controlled groups consisted of no acupuncture and sham acupuncture groups. The sham acupuncture included sham acupuncture at acupoints, sham acupuncture at non- or inappropriate points, sham LA, and adhesive tapes. Twenty-three trials (a total of 5598 participants) were included in this paper. The pooled CPR from all acupuncture groups was significantly higher than that from all controlled groups, whereas the LBR was not significantly different between the two groups. However, the results were quite distinct when the type of control and/or different acupuncture times were examined in a sensitivity analysis. The results mainly indicate that acupuncture, especially around the time of the controlled ovarian hyperstimulation, improves pregnancy outcomes in women undergoing IVF. More positive effects from acupuncture in IVF can be expected if a more individualized acupuncture programs are used.
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Advanced maternal age and increased risk of hypertensive disorders, a small-for-gestational-age infant and gestational diabetes? This study shows that it is all about the blood flow, not about age.
Early uterine artery Doppler velocimetry and the outcome of pregnancy in women aged 35 years and older
H. J. van den Elzen1, T. E. Cohen-Overbeek1, D. E. Grobbee2, R. W. P. Quartero1, Professor J. W. Wladimiroff1,*
Article first published online: 18 FEB 2003
DOI: 10.1046/j.1469-0705.1995.05050328.x
Keywords:
uterine artery;Doppler;pregnancy outcome;advanced age
Abstract
The objective of this paper was to determine whether first-and second-trimester uterine artery Doppler velocimetry are associated with pregnancy complications in women of advanced maternal age. A prospective cohort study of 352 women aged 35 years and older was studied. The pulsatility index (PI) values at 12–13 weeks of gestation were significantly associated with development of hypertensive disorders, a small-for-gestational-age infant and gestational diabetes, with a relative risk exceeding 4, 2 and 8, respectively for women with PI values in the highest quartile (> 1.67) of the PI distribution when compared with the lowest quartile of the PI distribution (< 1.24). At 23–27 weeks' gestation, uterine artery PI values were found to be associated with preterm delivery with a gestational age-adjusted risk of 10.6 for women with PI values in the highest quartile of PI (> 1.24) when compared with PI values in the lowest quartile of the PI distribution (< 1.09). No associations existed between uterine artery PI, antepartum hemorrhage and Cesarean section rate.
The risk estimates for any of the outcome parameters were not affected by maternal age.
Results indicate that hemodynamic changes detectable in the uterine artery as early as the first trimester of pregnancy are associated with an increased risk of hypertensive disorders, a small-for-gestational-age infant and gestational diabetes. A similar association exists in the late second trimester of pregnancy, with an increased risk of preterm delivery.
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Acupuncture and herbs increased IUI success rate from 39.4% to 65.5% in this study. The difference in the success rates is even more interesting, considering that the control group, who didn’t receive acupuncture was on average 2.3 years younger. The control group was 37.1 years old and the treatment group was 39.4. Normally, you’d expect much lower pregnancy rates in 39 year olds.
Acupuncture and Chinese herbal treatment for women undergoing intrauterine insemination
Keren Sela, Ofer Lehavi, Amnon Buchan, Karin Kedar-Shalema, Haim Yavetz, Shahar Lev-ari
Unit of Complementary Medicine, Tel Aviv Sourasky Medical Center, Affiliated to the Sackler Faculty of Medicine,
Tel Aviv University, 6 Weizmann St., Tel Aviv 64239, Israel
Fertility Research Institute, Tel Aviv Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
Aim: To assess the effect of traditional Chinese medicine (TCM, acupuncture and medicinal herbs) as a therapeutic adjuvant to ovulation induction with intrauterine insemination (IUI) procedures and evaluate its contribution to pregnancy and “take-home baby” rates.
Materials and methods: A comparative retrospective study was carried out in a university – affiliated municipal hospital. All women undergoing artificial insemination by donor spermatozoa (AID) and concomitantly treated with TCM were invited to participate. The enrolled women underwent weekly TCM in parallel with medical therapy. The treatment lasted between 2 and 36 cycles (equivalent to a time period ranging from one month to one year). The control group was comprised of women who underwent AID without TCM and whose data were retrospectively retrieved from hospital files. Pregnancy was assessed by human chorionic gonadotropin findings in blood 12–14 days after IUI. The birth rate was calculated during follow-up.
Results: A total of 29 women aged 30–45 years were enrolled in the study. The historical control group included 94 women aged 28–46 years.
Results over an average 4-5 months cumulative period:
1. Acupuncture and herbs plus IUI; average age 39.43 years
2. Control group – IUI (DI) only; average age 37.12 years
Women who combined TCM with the procedures for undergoing IUI had significantly higher pregnancy (OR = 4.403, 95% CI 1.51–12.835,
p = 0.007) and birth rates (OR = 3.905, 95% CI 1.321–11.549, p = 0.014) than the control group.
Conclusions: TCM appears to be beneficial as an adjunctive treatment in IUI procedures. Randomized controlled trials are needed to further assess the role of acupuncture and herbs in this setting.
A comprehensive article explaining how acupuncture may help prevent miscarriages.
BMC Complement Altern Med. 2012 Mar 22;12(1):20. [Epub ahead of print]
Acupuncture as a therapeutic treatment option for threatened miscarriage.
Betts D, Smith CA, Hannah DG.
Abstract
ABSTRACT:
BACKGROUND:
Threatened miscarriage involves vaginal bleeding in a pregnancy that remains viable. This is a common early pregnancy complication with increased risk factors for early pregnancy loss, preterm premature rupture of membranes (PPROM), preterm delivery, low birth weight babies and maternal antepartum haemorrhage. Currently there are no recommended medical treatment options, rather women receive advice that centres on a ‘wait and see’ approach. For women with a history of unexplained recurrent miscarriage providing supportive care in a subsequent pregnancy improves live birthing outcomes, but the provision of supportive care to women experiencing threatened miscarriage has to date not been examined.
DISCUSSION:
While it is known that 50-70 % of miscarriages occur due to chromosomal abnormalities, the potential for therapeutic intervention amongst the remaining percentage of women remains unknown. Complementary and alternative medicine (CAM) therapies have the potential to provide supportive care for women presenting with threatened miscarriage. Within fertility research, acupuncture demonstrates beneficial hormonal responses with decreased miscarriage rates, raising the possibility acupuncture may promote specific beneficial effects in early pregnancy. With the lack of current medical options for women presenting with threatened miscarriage it is timely to examine the possible treatment benefits of providing CAM therapies such as acupuncture.
SUMMARY:
Despite vaginal bleeding being a common complication of early pregnancy there is often reluctance from practitioners to discuss with women and medical personal how and why CAM may be beneficial. In this debate article, the physiological processes of early pregnancy together with the concept of providing supportive care and acupuncture are examined. The aim is to raise awareness and promote discussion as to the beneficial role CAM may have for women presenting with threatened miscarriage
Electrical and manual acupuncture stimulation affects estrous cyclicity and neuroendocrine function in a DHT-induced rat polycystic ovary syndrome model
Yi Feng, Julia Johansson, Ruijin Shao, Louise Mannerås Holm, Håkan Billig, Elisabet Stener-Victorin
Abstract
Both low-frequency electro-acupuncture (EA) and manual acupuncture improve menstrual frequency and decrease circulating androgens in women with polycystic ovary syndrome (PCOS). We sought to determine whether low-frequency EA is more effective than manual stimulation in regulating disturbed estrous cyclicity in rats with PCOS induced by 5?-dihydrotestosterone (DHT). To identify the central mechanisms of the effects of stimulation, we assessed hypothalamic mRNA expression of molecules that regulate reproductive and neuroendocrine function.
From age 70 days, rats received 2-Hz EA or manual stimulation of the needles five times/week for 4–5 weeks; untreated rats served as controls. Specific hypothalamic nuclei were obtained by laser microdissection, and mRNA expression was measured with TaqMan low-density arrays. Untreated rats were acyclic. During the last 2 weeks of treatment, seven of eight (88%) rats in the EA group had epithelial keratinocytes, demonstrating estrous cycle change (p= 0.034 vs. controls). In the manual group, five of eight (62%) rats had estrous cycle changes (ns vs. controls). mRNA expression of the opioid receptors Oprk1 and Oprm1 in the hypothalamic arcuate nucleus was lower in the EA group than in untreated controls. mRNA expression of the steroid hormone receptors Esr2, Pgr, and Kiss1r was lower in the manual group than in the controls.
In rats with DHT-induced PCOS, low-frequency EA restored disturbed estrous cyclicity but did not differ from manual stimulation group, although electrical stimulation lowered serum testosterone in responders, those with restored estrus cyclicity, and differed from both controls and the manual stimulation group. Thus, EA cannot in all aspects be considered superior to manual stimulation.
The effects of low-frequency EA may be mediated by central opioid receptors, while manual stimulation may involve regulation of steroid hormone/peptide receptors.
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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.
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 of using acupuncture in IVF can be expected if an appropriate control and more reasonable acupuncture programs are used.