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Acupuncture Improves the Pregnancy Outcome of IVF/ICSI

How acupuncture helps fertility is still unknown. There are at least three possible mechanisms by which acupuncture could influence pregnancy rate
There have been more controlled clinical trials published in the past years concerning acupuncture and IVF
Reference

Acupuncture, as an ancient Chinese system, has been scientifically demonstrated to help many clinical conditions. Recently the use of acupuncture as an adjuvant to conventional treatment such as in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) is becoming more common. This ancient technology is gaining popularity because of its promising outcomes to improve successful rate of the conventional procedures. With its nature of low cost and few side effects, acupuncture will play a role in the future integrated female healthcare system.

How acupuncture helps fertility is still unknown. There are at least three possible mechanisms by which acupuncture could influence pregnancy rate:

  1. Acupuncture could influence ovarian and uterine function via modulation of hypothalamic-pituitary-ovarian axis function producing normalization in secreting of hormones such as GnRH and LH. The anesthesia-like effects of acupuncture have been studied extensively. Acupuncture stimulates secretion of beta-endorphin, which has inhibitory effects on the central sympathetic system. This central mechanism further regulates the function of the hypothalamic-pituitary-ovarian axis.
  2. There is evidence that acupuncture increase blood flow to the ovarian and uterine arteries, thus thickening the endometrium and making it more receptive to the transferred embryo. This could be a response to a reduction in sympathetic nervous tone induced by acupuncture. It is well known that successful IVF requires optimal endometrial receptivity at the time of implantation. An increased blood flow to uterine arteries helps the receptivity for the procedure.
  3. The calming and anti-anxiety effects of acupuncture are likely to be very important to the success of the procedure. Stress and anxiety are seen as significant factors in failure to achieve pregnancy. Acupuncture is well known to have a relaxing effect and could be very helpful to provide relaxation before and after the IVF/ICSI procedure.

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There have been more controlled clinical trials published in the past years concerning acupuncture and IVF:

  • Westergaard et al. randomized 273 patients into one of the three groups: to receive acupuncture on the day of embryo transfer (ACU1), to receive acupuncture on the day of embryo transfer (ET) and again two days later (ACU2), or to receive no acupuncture (control). The pregnancy rate were significantly higher in ACU1 than in the control groups (42% versus 28% P=0.044). A significant overall improved outcome was also seen in combined acupuncture groups compared to the control group.
  • Paulus et al. randomized 160 patients to receive either acupuncture 25 minute before and after ET or a standard regimen with no acupuncture but with bed rest after ET. The clinical pregnancy rate was significantly in favor of acupuncture: 26.3% versus 42.5% (P=0.03). The authors concluded that acupuncture at the time of ET improves the clinical pregnancy rate in IVF/ICSI patients.
  • Stener-Victorin et al. included 147 patients considered to be poor responders in their trial: 53 received eight electroacupuncture treatments during hormonal stimulation and 94 received no acupuncture. The pregnancy rate in the acupuncture group was significantly higher than in the control group, 53% versus 38%. The authors concluded that acupuncture has a positive effect on pregnancy outcome in IVF.
  • Dieterle et al. included 225 infertile patients undergoing IVF/ICSI. 116 patients received luteal-phase acupuncture according to the principles of traditional Chinese medicine and 109 patients received placebo acupuncture. The clinical pregnancy rate and onging pregnancy rate (33.6% and 28.4% respectively) were significantly higher in acupuncture group than in control group (15.6% and 13.8%). The authors also concluded that luteal-phase acupuncture has a positive effect on the outcome of IVF/ICSI.

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Reference:

  • Dieterle et al., Effect of acupuncture on the outcome of in vitro fertilization and intracytophasmic sperm injection: a randomized, prospective controlled clinical study, Fertility and Sterility 2006;85(5):1347-1351
  • Johnson, Acupuncture prior to and at embryo transfer in an assisted conception unit, Acupuncture in Medicine 2006;24(1):23-28
  • Paulus et al., Influence of acupuncture on the pregnancy rate in patients who undergo assisted reproduction therapy, Fertility and Sterility 2002;77(4):721-724
  • Stener-Victorin et al., Use of acupuncture in female infertility and a summary of recent acupuncture studies related to embryo transfer, Acupuncture in Medicine 2006;24(4):157-163
  • Westergaard et al., Acupuncture on the day of embryo transfer significantly improves the reproductive outcome in infertile women: a prospective, randomized trial, Fertility and Sterility 2006;85(5):1341-1346

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