IVF

Acupuncture and IVF, when modern technique meets ancient acupuncture!

Acupuncture have been used in women’s health for over 2000 years in Chinese Medicine. They are safe in the hands of well-trained practitioners , even for pregnant women suffering various complications, e.g. hyperemesis gravidarum, headache, vomiting. Many studies have reported that acupuncture improved pregnancy rates among women undergoing IVF, which may relate to the following mechanisms, including regulating the function of the hypothalamic–pituitary–ovarian axis by changing the concentration of central opioids, improving blood circulation to the uterus and ovaries by inhibiting uterine central sympathetic nerve activity and reducing stress, anxiety or depression.
A research team from Nanjing Hospital of Traditional Chinese Medicine reviewed digital databases for relevant studies, including Embase, PubMed, Cochrane Library and some Chinese databases up to December 2018, for randomized controlled trials (RCTs) evaluating the effects of acupuncture on women undergoing IVF. They screened out 27 studies with 6116 participants in the study. The pooled clinical pregnancy rate (CPR) from all of acupuncture groups was significantly greater than that of control groups (RR 1.21, 95% CI: 1.07–1.38)! Meta-regression subgroup analysis showed a more significant benefit of acupuncture for repeated IVF cycle proportion (number of women with a history of prior unsuccessful IVF attempt divided by number of women included in each trial) ≥ 50% group (CPR: RR 1.60, 95% CI: 1.28–2.00; LBR: RR 1.42, 95% CI: 1.05–1.92), and this covariate explained most of the heterogeneity (CPR and LBR: adjusted R2 = 100 and 87.90%). Similar results were found between CPR and number of acupuncture treatments (CPR: p = 0.002, adjusted R2 = 51.90%), but not LBR.
Finally they concluded that acupuncture could be beneficial for IVF outcomes in women with a history of unsuccessful IVF attempt, and number of acupuncture treatments was a potential influential factor.

Which points to use?

Çoksüer et al, a research team from Turkey used PC6, SP8, LR3, DU20 and ST29 to assist IVF two times before and after embryo transfer in a single day. In addition, auricular points including ear point 55 (Shenmen), ear point 58 (Zhigong), ear point 22 (Neifenmi) and ear point 34 (Naodian) were also performed. The clinical pregnancy rate with acupuncture treatment was higher than that in the control group [60.9% (28/46) vs. 33.3% (14/42), respectively, P<0.05]. Besides the live birth rate in the acupuncture group was also higher than that in the control group [71.7% (33/46) vs. 31.0% (12/42), P<0.01).
What an amazing findings are they! Therefore they could accordingly conclude that acupuncture treatment on the day of embryo transfer dramatically improved fertility results in women who underwent in vitro fertilization/intra-cytoplasm sperm injection for reproduction.

Reference

Xie ZY, Peng ZH, Yao B, Chen L, Mu YY, Cheng J, Li Q, Luo X, Yang PY, Xia YB. The effects of acupuncture on pregnancy outcomes of in vitro fertilization: a systematic review and meta-analysis. BMC complementary and alternative medicine. 2019 Dec;19(1):131.

Smith CA, de Lacey S, Chapman M, Ratcliffe J, Norman RJ, Johnson NP, Fahey P. The effects of acupuncture on the secondary outcomes of anxiety and quality of life for women undergoing IVF: A randomized controlled trial. Acta Obstetricia et Gynecologica Scandinavica. 2019 Apr;98(4):460-9.

Çoksüer H, Barut MU, Bozkurt M, Agacayak E, Sak S, Demir M, Calıskan E. Acupuncture Enhances Chances of Pregnancy in Unexplained Infertile Patients Who Undergo A Blastocyst Transfer in A Fresh-Cycle. Chinese Journal of Integrative Medicine. 2019 Apr 1;25(4):298-302.

Picture: Blausen.com staff (2014). “Medical gallery of Blausen Medical 2014”. WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010. ISSN 2002-4436.