Acupuncture and
IVF
Effects of acupuncture on rates of pregnancy
and live birth among women undergoing in vitro fertilisation: systematic review and meta-analysis.
Manheimer E, Zhang G, Udoff L, Haramati A, Langenberg P, Berman
BM, Bouter LM. BMJ. 2008 Mar 8;336 (7643):517-8. PMID: 18258932
[PubMed - indexed for MEDLINE] PMCID: PMC2265327
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.
Conclusions: Current preliminary evidence suggests
that acupuncture given with embryo transfer improves rates of pregnancy
and live birth among women undergoing in vitro fertilisation.
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Effect of acupuncture on the outcome of
in vitro fertilization and intracytoplasmic sperm injection:
a randomized, prospective, controlled clinical study
Dieterl, S., Ying G., Hatzmann W., Neuer A., Fertil Steril.May
2006, 85 (5): 1347-51. Epub 2006 Apr 17. PMID: 16616748
[PubMed - indexed for MEDLINE]
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. Patients: Two hundred
twenty-five infertile patients undergoing IVF/ICSI. Interventions:
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.
Results: 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%).
Conclusions: Luteal-phase acupuncture has a positive
effect on the outcome of IVF/ICSI.
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Acupuncture on the day of embryo transfer
significantly improves the reproductive outcome in infertile
women: a prospective, randomized trial
Westergaard LG et al. Fertil Steril.
2006 May;85(5):1341-6; Epub 2006 Apr 5.
PMID: 16600232 [PubMed - indexed for MEDLINE] Fertility
Clinic Trianglen, Hellerup, Denmark. l.g.westergaard@dadlnet.dk
In a Danish study to investigate the benefits of acupuncture in
assisted reproduction (IVF and ICSI), women were randomly assigned
to three groups. One received acupuncture only on the day of embryo
transfer, one received additional acupuncture two days later, and
a control group received no acupuncture. Clinical and ongoing pregnancy
rates were significantly higher in the acupuncture groups than
the controls, but the additional treatment given two days after
transfer appeared to confer no additional benefit.
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Acupuncture prior to and at embryo transfer in an
assisted conception unit – a case serie
Johnson D. Acupuncture
in Medicine (2006) 24; 1: 23-28;quoted in JCM 84 June 2007.
Over a period of three years in a private practice 22
patients entering assisted reproduction therapy were given
acupuncture. Treatment was given, usually weekly, during the
IVF cycle and immediately before and after embryo transfer.
The success rate was 57.7% compared to 45.3% for patients in
the IVF unit not treated with acupuncture.
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Acupuncture and good prognosis IVF patients: Synergy
P. C. Magarelli, D. K. Cridennda, M. Cohen.
Reproductive Medicine & Fertility Center, Colorado Springs,
CO; East Winds Acupuncture, Inc., Colorado Springs, CO); quoted
in JCM 78 June 2005.
Objective: To determine the role of electro stimulation
acupuncture and traditional combined with auricular acupuncture
on IVF outcomes in good prognosis patients.
Total IVF cases 114, 53 with Acupuncture (Ac) and 61 without Acupuncture
(Non-Ac).
Conclusions: The use of adjunctive therapies
in IVF protocols is gaining popularity. This is also the first
publication of Birth outcome data in Acupuncture treated IVF patients.
Acupuncture significantly increased birth outcomes; it significantly
decreased ectopic pregnancies and miscarriage rates. These data
uniquely support a definitive role of both electrostimulation and
traditional acupuncture combined with auricular acupuncture in
IVF in good prognosis IVF patients.
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A Randomized Study Evaluating Acupuncture as an
Adjunct to IVF
Rodolfo Quintero, M.D., Wendy Yu, L.Ac.,
Brandon Horn, L.Ac., J.D., Daoshing Ni, D.O.M., Barry Schifrin,
MD., Brian Acacio, M.D., Department of Obstetrics and Gynecology,
Glendale Adventist Medical Center (GAMC) and the Eastern Center
for Complementary Medicine, Glendale, CA); Journal
of Fertility and Sterility 2004;84,quoted in JCM 78 June 2005.
Background and Significance: Acupuncture is based
on patterns of energy flow (Qi) through a network of meridians.
Maintenance of Qi is essential for health, while blockage may provoke
disease. Acupuncture works by unblocking the various types of stagnation
that can occur along these channels. After Paulus et. al demonstrated
the benefit of acupuncture to IVF (Fertil Steril Apr 2002),
many IVF centers began offering these services.
Objective: The purpose of this study was to determine
if there are benefits of standard acupuncture compared to sham
acupuncture as an adjunct to IVF.
Conclusions: Our study shows a significantly
lower amount of gonadotropins used when IVF is combined with standard
acupuncture. A 70% pregnancy rate was also achieved with standard
acupuncture and IVF, compared to 25%. Larger prospective trials
are necessary.
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IVF and pregnancy
October 2004 meeting of the American
Society for Reproductive Medicine; quoted in JCM 78 June
2005.
A German study showed that adding acupuncture to the treatment
protocol of patients receiving IVF increased their chances of becoming
pregnant by 50%. Now a further study carried out at the Reproductive
Medicine and Fertility Centre in Colorado Springs, USA, has compared
the pregnancy rates of 114 women, half of whom received acupuncture
before and after embryo transfer, whilst the other half underwent
transfer without acupuncture (control group). The acupuncture group
obtained a 51% pregnancy rate and an 8% miscarriage rate compared
to 36% and 20% respectively in the control group. Acupuncture also
was found to reduce the risk of tubal pregnancy and increase the
live birth rate.
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Acupuncture and IVF Poor Responders: A
Cure?
P.C. Magarelli, D.K. Cridennda. Fertility
and Sterility, Volume 81, Supplement 3, April 2004, Page 20.
P.C. Magarelli, D.K. Cridennda. Reproductive Medicine & Fertility
Center, Colorado Springs, CO.
Background and Significance: The utility of acupuncture
in the treatment of infertility has been demonstrated in two controlled
studies. The first study determined the effect of reducing the
Pulsatility Index (PI) of the uterine artery on reproductive outcomes;
the second study described a Pre/Post embryo transfer protocol
that enhanced overall pregnancy rates (PR). There are no studies
that have utilized both techniques.
Objective: The purpose of the study was to determine
the influence of these two acupuncture protocols on IVF outcomes
and secondly to identify the appropriate patient groups that would
most benefit from this adjunctive therapy.
Conclusions: Significant increases in pregnancy
outcomes were confirmed by this study and the data uniquely supported
the advantage of acupuncture in patients with normal PI (prior
studies were done on patient with PI > 3). We also demonstrated
that both acupuncture treatment protocols could be used together
with a synergistic effect. Finally, this study is the first to
demonstrate that the use of acupuncture in patients with poor
prognoses (elevated Peak FSH, longer history of infertility,
poor sperm morphology) can achieve similar pregnancy rates to
normal prognosis patients.
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