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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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Aupuncture 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.