Acupuncture increases IVF success
The beneficial effect of acupuncture on fertility treatment has once again been highlighted by the results of a major scientific study. The research found that women undergoing IVF treatment were much more likely to have a successful pregnancy if they also had acupuncture treatment on the day of embryo transfer.
Acupuncture carried out on the day of embryo transfer was found to increase the chances of having live birth from one in five to one in three. The systematic review and meta-analysis, published as part of the Cochrane Database of Systematic Reviews, and carried out by a team from the University of Southampton, identified a total of 16 trials involving acupuncture and assisted conception, of which 13 were considered high enough quality to be included in the study.
These involved a total of more than 2000 IVF patients. Analysis of the pooled results led the authors to conclude that acupuncture around the time of embryo transfer achieved a higher live birth rate of 35% compared with 22% without active acupuncture.
(Acupuncture and assisted conception. Cochrane Database Syst Rev. 2008 Oct 8;(4):CD006920).
Acupuncture boosts fertility
A review of the medical literature on acupuncture and female fertility published in the journal Fertility and Sterility has shown that acupuncture can help reduce stress, increase blood flow to the reproductive organs and normalise ovulation and the menstrual cycle.
Therefore, women struggling to get pregnant may want to add acupuncture to their roster of fertility-boosting treatments, according to study author Dr. Raymond Chang of Cornell University. Stress is known to adversely affect ovulation, and therefore it is logical that acupuncture would assist normal ovulation through the release of beta-endorphins.
Many previous studies examined the benefits of acupuncture when added to other fertility treatments. Recent reports have shown that women who incorporate acupuncture into their in-vitro fertilisation (IVF) treatment are more likely to become pregnant than those who use IVF alone, and that women who used acupuncture without any other fertility treatments were just as likely to conceive in the same period of time as women who took a fertility drug.
(Fertility and Sterility 2002;78:1149-1153).
Acupuncture increases IVF success rate
A meta-analysis of 7 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 7 clinical trials (selected as eligible from a total of 108), all published since 2002 and carried out in 4 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.
(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).
Acupuncture and IVF
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.
- Treatment during the cycle emphasised points such as:
- Baihui DU-20, Taichong LIV-3, Sanyinjiao SP-6, Zusanli ST-36, Neiguan P-6, Guilai ST-29 and Hegu L.I.-4 and ear points Shenmen, Neifenmi, Zhigong and Naodian.
- Pre-transfer treatment was Baihui DU-20, Taichong LIV-3, Diji SP-8, Neiguan P-6, Guilai ST-29 and the four ear points.
- Post-transfer treatment was Sanyinjiao SP-6, Xuehai SP-10, Zusanli ST-36, Hegu L.I.-4 and the four ear points.
- The success rate was 57.7% compared to 45.3% for patients in the IVF unit not treated with acupuncture.
(Johnson D. Acupuncture prior to and at embryo transfer in an assisted conception unit – a case series. Acupuncture in Medicine (2006) 24; 1: 23-28).
Acupuncture Improves Sperm Quality
A study of the effect of acupuncture on sperm quality in men suffering infertility of unknown cause, found that after twice weekly treatment for five weeks, there were fewer structural sperm defects (acrosome position and shape, nuclear shape, axonemal pattern and shape, and accessory fibres of sperm organelles) and an increase in the number of normal sperm ejaculated. Other sperm abnormalities such as immature or dead sperm were not affected.
Acupuncture was given at Guanyuan REN-4, Shenshu BL-23, Ciliao BL-32 and Taixi KID-3 with Zusanli ST-36, Xuehai SP-10, Sanyinjiao SP-6, Guilai ST-29 and Baihui DU-20 as secondary points.
Deqi was obtained at all needling sites and aimed to be transmitted from Shenshu BL-23 and Ciliao BL-32 to the sacral or perineal area and the anterior hypogastric region.
(Fertility and Sterility, Volume 84, Issue 1 , July 2005, Pages 141-147).
Acumoxa Significantly Improves Sperm Morphology
In a small Brazilian study, 19 male patients with sperm abnormalities (sperm count, motility and morphology) were randomly assigned to receive true (treatment group) or sham (control group) acupuncture and moxibustion treatment.
The treatment group were needled at Qichong ST-30, Taixi KID-3, Zusanli ST-36, Hegu L.I.-4, Sanyinjiao SP-6, Gongsun SP-4, Taichong LIV-3 and Neiguan P-6 (with deqi), and received moxibustion (until the skin was reddened) at Shenshu BL-23, Zhishi BL-52, Sanjiaoshu BL-22, Mingmen DU-4, Ciliao BL-32, Qihai REN-6, Guanyuan REN-4, Zhongji REN-3, Pishu BL-20, Weishu BL-21, Shimen REN-5, Taiyuan LU-9, Feishu BL-13, Gaohuangshu BL-43, Xinshu BL-15 and Zigong (M-CA-18).
Treatment was given twice a week for 10 weeks. The control group received needling and moxibustion at non-points. At the end of treatment, patients in the treatment group showed a significant improvement in sperm morphology ( i.e. normally formed sperm). There was no significant difference between the groups in terms of seminal fluid volume, sperm count or motility.
(Asian J Androl 2003 Dec; 5: 345-348).
ICSI Used More Than IVF
There is now mounting evidence that infertility may be affecting more men than women. Intra-cytoplasmic sperm injection (ICSI), in which a single sperm is injected straight into an egg and is normally used in cases where the sperm is of too poor quality to permit conventional fertilisation has become the most commonly used technique in Europe and now outnumbers conventional IVF.
In Merseyside and Cheshire, the number of men seeking treatment for infertility has risen by nearly 70% in the past four years with ICSI now accounting for 60% of the ICSI / IVF treatments carried out at the Liverpool Women’s Hospital.
(European Society of Human Reproduction and Embryology annual conference, Copenhagen, 2005).
Acupuncture reduces pain and other side effects in IVF patients
In this study, 286 women were randomly assigned to receive either electroacupuncture plus para-cervical block or alfentanil (a powerful analgesic) plus para-cervical block during oocyte aspiration (egg retrieval). Both interventions induced adequate analgesia, however the electroacupuncture group reported significantly less abdominal pain, other pain, nausea and stress than the medication group, and required significantly less additional analgesic medication.
(Hum Reprod 2003; 18: 1454-60).
Acupuncture increases pregnancy rates in IVF patients by 50%
A recent study in Germany (the Christian-Lauritzen-Institut in Ulm) has shown that adding acupuncture to the treatment protocol of IVF patients increases their chances of becoming pregnant by nearly 50%.
160 IVF patients were randomly assigned to two groups. In the study group, patients received acupuncture on the Spleen, Stomach and Large Intestine channels as well as the ear – a single treatment before transfer and another one after embryos had been transferred.
The difference between pregnancy rates for the two groups was notable. When patients were examined using ultrasound six weeks after their IVF procedures, the pregnancy rate in the acupuncture group was 42.5% (34/80), compared to 26.3% (21/80) in the control group
(Fertility and Sterility, Vol. 77, No. 4, April 2002).
Acupuncture during embryo transfer increases pregnancy rates
A 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.
(October 2004 meeting of the American Society for Reproductive Medicine).
Acupuncture helps produce more follicles in women undergoing ICSI
6 female patients being treated for infertility by ICSI were referred to acupuncture due to difficulty with follicle production despite maximum gonadotropin therapy. Acupuncture was given at the same time that they began follicle-stimulating hormone injections: 3 or 4 twice-weekly treatments, on days 1-3, 4-6, 7-9 and in some cases 9-11, with the final treatment on the day of or prior to egg retrieval.
Points Mingmen DU-4, Shenshu BL-23 were used at every treatment, whilst points Gongsun SP-4 with Neiguan P-6, and Zhaohai KID-6 with Lieque LU-7 were alternated. Additional points were added on an individual basis, including Taichong LIV-3, Guanyuan REN-4, Qihai REN-6, Ganshu BL-18, Pishu BL-20, Kunlun BL-60 and Shenmai BL-62.
Three of the women produced more follicles with acupuncture than prior to acupuncture (mean number of follicles with acupuncture was 11.3 vs 3.9 prior to acupuncture; P=.005).
All 3 became pregnant although only 1 continued the pregnancy past the 1st trimester. None of the women became pregnant during the non-acupuncture cycles.
Acupuncture also appeared to increase the estradiol levels.
The authors conclude that acupuncture may be a useful adjuvant to gonadotropin therapy among women undergoing intracytoplasmic sperm injection.
(Acupuncture Treatment For Infertile Women Undergoing Intracytoplasmic Sperm injection, Emmons, S., Patton, P. Medical Acupuncture, Vol.12 / No.2).
