15. March 2016 · Comments Off · Categories: Acupuncture, IVF, Pregnancy, TEAS
24. September 2015 · Comments Off · Categories: IVF

Individualised treatment with ‘whole-systems traditional Chinese medicine’ (WS-TCM, that includes a combination of acupuncture, Chinese herbal medicine and dietary and lifestyle recommendations) may be of benefit when added to IVF treatment, according to an American research team. In a retrospective cohort study, 1231 IVF patient records were reviewed to assess the effect of adjuvant WS-TCM on IVF outcomes. Three groups of patients were compared: IVF with no additional treatment; IVF plus acupuncture on the day of embryo transfer; and IVF plus WS-TCM. Of 1069 non-donor and 162 donor IVF cycles WS¬TCM was associated with greater odds of live birth compared with all other groups. (Impact of whole systems traditional Chinese medicine on in vitro fertilization outcomes. Reprod Biomed Online. 2015 Feb 24. pii: S1472-6483(15)00092-9. [Epub ahead of print]).

Acupuncture can reduce anxiety symptoms in women undergoing IVF, according to a team of Brazilian researchers.  Forty-three women undergoing IVF were randomly allocated to two groups: a test group who received verum acupuncture (at Shenmen HE-7, Neiguan P-6, Shanzhong REN-17, Baihui DU-20 and Yintang M-HN-3), and a control group who had needles inserted in areas near, but not corresponding to, acupuncture points. Treatment consisted of four weekly sessions. The mean anxiety score after the four-week experimental period was significantly lower in the test group compared with the control group (19.4 vs 24.4). (Effect of acupuncture on symptoms of anxiety in women undergoing in vitro fertilisation: a prospective randomised controlled study. Acupunct Med. 2012 Apr 12. [Epub ahead of print]).

Women receiving acupuncture on the day of embryo transfer (ET) perceive less stress, which may play a role in improving their chances of becoming pregnant. In an observational, prospective, cohort study, American investigators studied 57 infertile patients undergoing IVF or ICSI. Patients underwent ET with or without acupuncture as part of their standard clinical care. 64.7% of women who received acupuncture achieved pregnancy, compared with 42.5% of those who did not have acupuncture. Upon further analysis, in which patients were stratified by donor recipient status, only non-donor recipients showed a potential improvement in pregnancy rates (35.5% without acupuncture vs. 55.6% with acupuncture). The women who received acupuncture reported lower perceived stress scores pre-ET and post-ET than those who did not. Women with decreased perceived stress scores compared to baseline were found to have higher pregnancy rates than those who did not demonstrate this decrease, regardless of acupuncture status. (The relationship between perceived stress, acupuncture, and pregnancy rates among IVF patients: a pilot study. Complement Ther Clin Pract. 2010 Aug;16(3):154-7).

A meta-analysis of seven clinical trials in which acupuncture was used to support embryo transfer during IVF has concluded that it improves rates of pregnancy and live birth. Dutch and American researchers analysed results from seven clinical trials (selected as eligible from a total of 108), all published since 2002 and carried out in four Western countries. They included data on 1366 women and compared acupuncture given within one day of embryo transfer, with sham acupuncture or no additional treatment. All except one used a similar acupuncture protocol (based on Paulus et al). The analysis showed that combining real acupuncture with embryo transfer was associated with significant and clinically relevant improvements in clinical pregnancy rate. Women who underwent acupuncture were 65% more likely to have a successful embryo transfer procedure and 91% more likely to have a live birth. On the basis of ‘number needed to treat’, this means that ten women undergoing IVF would need to be treated with acupuncture to bring about one additional pregnancy. (Effects of acupuncture on rates of pregnancy and live birth among women undergoing in vitro fertilisation: systematic review and meta-analysis. BMJ. 2008 Mar 8;336(7643):545-9).

Or does it?

However, a new randomised controlled trial of acupuncture for embryo transfer support, carried out in America, found no increase in clinical pregnancy rate. The study, which involved 150 patients, also used the Paulus acupuncture point protocol and compared it with lying quietly as a control. The use of acupuncture was not associated with increased pregnancy rates, but patients who received it reported feeling relaxed and optimistic about their treatment. (The impact of acupuncture on in vitro fertilization outcome. Fertil Steril. 2008 Mar 1 [Epub ahead of print])

A literature review from the USA provides an overview of the use of acupuncture as an adjunctive therapy for in vitro fertilisation (IVF). The authors used biomedical and acupuncture databases cross-referenced with published data, personal libraries and Chinese medicine textbooks. They concluded that limited but supportive evidence from clinical trials and case series suggests that acupuncture may improve the success rate of IVF and the quality of life of patients undergoing the process. They urged caution in interpreting study results, due to design limitations, and commented that the acupuncture described was often not consistent with traditional Chinese medical principles. Acupuncture was judged to be a safe adjunctive therapy. The reviewed literature suggested four possible mechanisms by which acupuncture could improve IVF outcomes: modulation of neuroendocrine factors: improvement of blood flow to the uterus; modulation of cytokines; and reduction of stress, anxiety and depression.  The need for more high-quality studies was noted.  (In vitro fertilization and acupuncture: clinical efficacy and mechanistic basis.  Altern Ther Health Med. 2007 May- Jun:13(3):38-48).

A randomised prospective controlled clinical study examined the effect of luteal-phase acupuncture on the outcome of in vitro fertilisation/intracytoplasmic sperm injection. 116 patients receiving acupuncture according to the principles of traditional Chinese medicine were compared with a group of 109 receiving placebo acupuncture. In both groups, acupuncture was carried out immediately after embryo transfer. The TCM acupuncture group received needling at Guanyuan REN-4, Qihai REN-6, Guilai ST-29, Neiguan P-6, Diji SP-8 and Xuehai SP-10 with ear seeds placed at auricular points Shenmen, Zigong, Neifenmi and Pizhixia (left in place for two days and pressed twice daily for 10 minutes). The placebo group received acupuncture designed not to influence fertility (Sidu SJ-9, Xiaoluo SJ-12, Fengshi GB-31, Zhongdu GB-32, Yanglingquan GB-34; ear seeds at Shangzhi, Fengsi, Shisheng, Jian). Three days after embryo transfer, all patients received a second acupuncture treatment. For the placebo group, needling was the same as previously, while the TCM acupuncture group were needled at Hegu L.I.-4, Sanyinjiao SP-6, Zusanli ST-36, Taixi KID-3 and Taichong LIV-3. Both groups had ear seeds placed on the other ear at the same points as previously (again pressed twice daily for two days). Clinical pregnancy rate and ongoing pregnancy rate (33.6% and 28.4% in the TCM acupuncture group were significantly higher than in the placebo acupuncture group (15.6% and 13.8%).

(Effect of acupuncture on the outcome of in vitro fertilization and intracytoplasmic sperm injection: a randomized, prospective, controlled clinical study. Fertil Steril. 2006 May;85(5):1347-51)