Auricular acupuncture versus cognitive behavioural therapy in the discontinuation of hypnotic drug usage, and treatment effects on anxiety, depression and insomnia symptoms − a randomised controlled study

Ear Acupuncture was seen to reduce anxiety and depression in this study on 57 participants with insomnia disorder and long term use of hypnotic drugs. 74% of them managed to discontinue their hypnotic drug consumption post-treatment.

Bergdahl L et al, Eur Jn Int Med, Vol 16, 2017,  15-21
European Journal of Integrative Medicine

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A Comparison of Stress Levels in Women Undergoing Single Versus Multiple Acupuncture Session Prior to Embryo Transfer

C. Sutton, MD et al, 2015 Fert Stert, Vol 103, Issue 2, Supplement, Pages e36–e37
Fertility and Sterility
This report is a retrospective study done on 78 women undergoing IVF, who had acupuncture for more than a month prior to, or only on the day of, embryo transfer. A standardised questionnarie (the Perceived Stress Scale) found that women who had acupuncture in the lead up to embryo transfer had significantly lower stress scores than those who had acupuncture on the day of transfer.
This is not a randomised controlled trial, and therefore does not provide sufficient evidence for claims about stress management of IVF patients. However it indicates the way for future trials. And is of particular interest in showing the effect of dose in acupuncture treatments.

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Relationship between psychological stress and reproductive outcome in women undergoing in vitro fertilization treatment: Psychological and neurohormonal assessment

Yuan An et al, . 2013 Jan; 30(1): 35–41

Journal of Assisted Reproduction and Genetics

264 women undergoing IVF were tested periodically for cortisol and noradrenaline status. Additionally they completed assays to determine anxiety and depression. Lower levels of the stress hormones were found in women who were successful in conceiving and having a live birth. This is possibly one of the mechanisms whereby acupuncture may help to improve IVF outcomes.

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Auricular Acupressure Reduces Anxiety Levels and Improves Outcomes of in Vitro Fertilization

sr_nature-228x300Fan Qu et al, Sci Rep Nature, (2014), 4, Article number: 5028

Scientific Reports, Nature Publishing

In a randomised controlled trial, 300 women who were doing IVF due to blocked tubes, were divided into groups that received stimulation to auricular acupuncture points (small seeds were taped onto 3 points related to nervous system or ovary and uterus function) or to sham points or no treatment. The women in the active treatment group had a higher pregnancy rate than did those in the sham or control groups. Additionally they reported less stress and anxiety.

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Effects of work and life stress on semen quality

Janevic T et al, Fert Stert 2014, vol 102, p 530-538

Fertility and Sterility

When nearly 200 men were assessed for stress and semen quality, a clear association was apparent between stressful life events and perceived stress and lower sperm count. However work related stress did not have an impact.

This study is included here, since acupuncture is well known for its beneficial impact on perceived stress.

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Preconception stress increases the risk of infertility: results from a couple-based prospective cohort study—the LIFE study

Lynch CD et al, Hum. Reprod. (2014) 29 (5): 1067-1075.
Human Reproduction 

When 400 women who were trying to conceive offered samples of saliva for stress marker analysis (alpha amylase) over a period of a year, it was found that those with the highest levels were twice as likely as those with the lowest levels to experience infertility. It is not clear exactly how stress reduces fertility but this study was able to show that it was not reduced sexual intercourse or interference with ovulation. However it is possible that there may be stress induced alterations in gamete transport or the development of an autoimmune state unfavourable for implantation. Higher levels of alpha amylase occur when there is elevated adrenalin in the blood stream. Read More

Effect of Acupuncture on Symptoms of Anxiety in Women Undergoing In Vitro Fertilisation

Isoyama D et al, Acupunct Med. 2012 Jun;30(2):85-8.
Acupuncture in Medicine (BMJ)

In this randomised controlled trial, the authors found that using acupuncture points that specifically reduce stress, significantly lowered anxiety levels of women undergoing IVF (as measured on the Hamilton Anxiety Rating Scale) when they were treated once a week before and during the IVF cycle. Other women who were also treated with acupuncture once a week but with non acupuncture points did not experience the same benefit.   Read More

The effect of medical clowning on pregnancy rates after in vitro fertilization and embryo transfer

Friedler S et al, Fertility and Sterility 2011, Vol 95, Issue 6 , Pg 2127
Fertility and Sterility  

In this partly randomised prospective trial, Dr. Friedler and colleagues tracked 219 women undergoing IVF treatment and treated half of them to a medical clown’s 15-minute routine of jokes, magic tricks and other clowning immediately after their embryos were implanted. Those women who had a good laugh after their transfer fell pregnant more often than did the control group. The authors note that ways to relieve stress at ET may be useful.   Read More

Emotional distress in infertile women and failure of assisted reproductive technologies: meta-analysis of prospective psychosocial studies

Boivin J et al, BMJ 2011;342:d223

British Medical Journal

A large meta-analysis of 14 prospective studies between 1985 and 2009, found no relationship between pre IVF emotional distress and IVF outcomes.  The authors state that their meta-analysis is probably not the final word on
emotional distress and ART and since the publication of this meta-analysis there have been 6 more studies published that might add further consideration to the conclusion.

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Stress reduces conception probabilities across the fertile window: evidence in support of relaxation.

Buck Louis GM et al, Fertil Steril. 2011, 95, 7, pg 2184 – 2189
Fertility and Sterility

In a prospective cohort study involving 274 women, stress marker levels were assessed and related to conception rate. The study showed a clear relationship with higher stress levels (as measured by alpha-amylase) and reduced conception rates.  Read More

The relationship between perceived stress, acupuncture, and pregnancy rates among IVF patients: A pilot study

Balk J et al, Complement Ther Clin Pract. 2010 Aug;16(3):154-7).
Complementary Therapies in Clinical Practice 

In a small prospective cohort study of 57 IVF patients, some investigators aimed to determine if acupuncture affects the levels of perceived stress at the time of embryo transfer, and whether either acupuncture or changes in stress levels play a role in the success rate in IVF.  The patients who received acupuncture in this study had both higher rates of pregnancy, and lower levels of stress both before and after embryo transfer. They postulated that reducing stress at the time of embryo transfer could result in less vasoconstriction and improved uterine receptivity. Read More

The relationship between perceived stress, acupuncture, and pregnancy rates among IVF patients: A pilot study

Balk J et al, Compl Therapies in Clinical Practice 2010,16,154–157
Complementary Therapies in Clinical Practice

A pilot study at a university IVF clinic in Pittsburgh investigated the relationship between acupuncture, stress and pregnancy rates in IVF patients. They cautiously concluded that a lower stress level may contribute to higher pregnancy rates and that acupuncture was associated with this result.

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